Hemifacial microsomia is a condition in which half of one side of the face is underdeveloped and does not grow normally. It is also called craniofacial microsomia. The condition is sometimes confused with Goldenhar syndrome a rare congenital condition. There is variety of deformities associated with HFM involving different parts of face in varying degree of severity and some areas may not be affected at all. In 10 to 15 percent of cases, both sides of the face are affected, often times asymmetrically. Commonly involved areas of face are;
Orbit/Eye
Jaws/mandible
Ear (external & middle)
Some of cranial nerves
Side of the skull
Cheek
Teeth
Management of Hemifacial microsomia needs collaborative team approach which includes plastic surgeon, maxillofacial surgeons and dentists and orthodontists, anesthetist and pediatricians. Newborn is initially evaluated for urgent problems and the managed with team collaboration In severe form neonate may require urgent tracheostomy for breathing problems and surgery for eye support in case of exposure. Definitive surgical intervention is divided in different age groups range from soft tissue reconstruction of lip, cheek, reconstruction of ear and bony reconstruction of mandible and jaw.
1. Is child with HFM is normal If there is no associated brain problem, child is normal
2. How is HFM treated It is treated in collaboration with other specialties dealing with urgent problems first. Then different surgeries are planned according to age of child.
3. What is Goldenhar syndrome Goldenhar syndrome is rare congenital condition resembling Hemifacial microsomia. It is characterized by abnormal development of the eye, ear and spine and lip. It can affect heart, kidneys, nervous system and lungs.
4. Does hemifacial microsomia get worse with age? There is no "catch up " growth on the affected side of the face and that these patients
always become more deformed with age. The psychological problems also increase with time and progression of the facial deformity. (copied from google)
Outcome depends on the location and size of the fistula and status of surrounding tissues. Although most of the fistula closes after the surgery, some may recur and requires further surgery.
It usually takes less time than the original hypospadias repair and completes in less than an hour.
The surgery is performed under general anaesthesia and as a day care procedure. Patient can go home the same day after recovery from anaesthesia.
The most common complication is recurrence of the defect. Others complications include infection, difficulty in urination and stricture formation
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