Hope For My Child’s Future...
“When I first saw Eddie’s face, words can’t describe the devastation I
felt. Hope for my child’s future was replaced by a feeling of
powerlessness. How could we protect him from the pain he would find?”
“The Little Baby Face has given Eddie a beautiful face and given us hope
for his future. Thank you, thank you, thank you...”
— Sandra Hobbs, Winslow, Arizona
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About Facial Deformities
Hemifacial Microsomia
What is Hemifacial Microsomia?
Hemifacial microsomia (HFM) is a condition that affects bone, muscle,
fat and nerves of the face. The
deformities in HFM are on a spectrum from a mild presentation with
slight asymmetry to severe with absence of facial structures. This
condition is progressive and becomes more apparent as the individual
grows.
How often does Hemifacial Microsomia occur?
HFM is the second most common facial deformity. It occurs in
approximately 1 in every 5600 births. The cause is unknown and there is
no sex predilection.
Facial Growth
Asymmetric growth is an early manifestation in HFM. This presentation
is accentuated by the deficiencies in mandibular (lower jaw) growth,
lack of soft tissue bulk and weakness of the muscles in the face. The
unaffected side grows normally in all dimensions while the affected side
does not. The chin deviates toward the affected side. The short jaw
restricts normal downward growth of the maxilla (upper jaw) and produces
a cant of the bite.
Classification in Hemifacial Microsomia
HFM most common classification system is the O.M.E.N.S. classification
first described by Vento and colleagues. OMENS stands for orbit (eye),
mandible (lower jaw), ear, nerve and soft tissue (skin, fat and muscle).
These structures are each rated from a normal state designated 0 to
severe 3. Accurate classification of HFM is imperative to formulate a
comprehensive treatment plan.
Treatment in Hemifacial Microsomia
Patient age and skeletal type determines the treatment course. Early
treatment, patients in deciduous dentition (baby teeth), is confined to
the severe deformities. Mixed dentition treatment approximately age
6-12 is multidisciplinary involving mandibular correction to allow for
normal maxillary growth followed by orthodontic treatment (braces) to
align the teeth. End stage correction (after growth is complete) usually
older than 16, involves surgery on both the mandible and maxilla. Ear
reconstruction or revision can be carried out throughout the treatment
algorithm depending on treatment plan.
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