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Hemifacial Microsomia

What is hemifacial microsomia?

Children with hemifacial microsomia have a small or underdeveloped part of the face, usually the ear and jaw. The eye, cheek and neck may also be affected.

This is the second-most common facial birth defect after clefts.

Hemifacial microsomia has many other names, including craniofacial microsomia, first and second branchial arch syndrome, otomandibular dysostosis, oculo-auriculo-vertebral sequence, facio-auriculo vertebral syndrome, Goldenhar syndrome and lateral facial dysplasia.

How much experience do you have treating hemifacial microsomia?

Our team has a great deal of experience taking care of children with HFM. It is one of the most common problems that we treat. Right now we are treating 71 children.

Each year we have at least 13 new children come to our Center for treatment. Each year we perform an average of 27 surgeries for this condition.

Who gets hemifacial microsomia?

We don't know why children are born with hemifacial microsomia, but we believe that something affects the development of the face during early pregnancy because the process starts in the first three months. However, it is clear that HFM is not caused by anything the parent did or did not do.

For most children, hemifacial microsomia is not inherited and it won't be passed on from a parent to a child.

However, if both parents have had a child with hemifacial microsomia, the chance that they will have another child with HFM is about 3%.

Rare families have a higher chance of having another child with HFM. For children who have a family history of relatives with similar facial differences, we recommend a referral to a geneticist and/or a genetic counselor.

The counselor will talk about the chance of having another child with similar differences, as well as other family planning issues.

What does a baby with hemifacial microsomia look like?

Some babies have a slightly smaller jaw with a small skin tag (tiny raised piece of skin ) in front of an otherwise normal-looking ear.

Other babies have more noticeable differences with one side of the face looking much smaller than the other or with a very small, abnormally shaped ear.

Most babies with HFM have facial differences, but they do not have any other medical problems. Some babies with hemifacial microsomia do have effects in other parts of their body.

Common features of hemifacial microsomia include:

Ears

  • Microtia (small ear)
  • Aural atresia (no ear canal)
  • Preauricular tags or facial tags (tags of skin in front of the ear)
  • Other ear differences

Face

  • Facial palsy (difficulty with muscle movement)
  • Small cheekbone
  • Epibulbar dermoid (pinkish-white growth on the eye)
  • Macrostomia (wide mouth)
  • Cleft lip and palate

Jaw and Teeth

  • Trismus (limited opening of the mouth)
  • Shortness of lower jaw
  • Crooked lower jaw
  • Malocclusion (bad bite)