Hemifacial Microsomia (HFM) in Children
What is hemifacial microsomia in children?
Hemifacial microsomia (HFM) is a congenital problem. This means that your child is
born with it. In this condition, one side of your baby’s face is underdeveloped (hemi
means half). HFM usually only affects one side of the face. Sometimes both sides may
be affected. This condition shares features with another condition called Treacher
What causes HFM in a child?
This condition often happens by chance. It commonly develops during the fetal stage
of pregnancy at around 4 weeks gestation because of vascular problems causing poor
blood supply to the face. It may also run in some families. HFM may be passed on (inherited)
in the following ways:
Autosomal dominant. This means that only one parent passes the gene on to the child. Each child has a
1 in 2 chance of having the condition.
Autosomal recessive. This means that both parents must have the gene to pass it on. Each child has 1 in
4 chance of having HFM.
Multifactorial. This means that many factors are involved. The factors are often genetic and environmental
(such as trauma during pregnancy).
This condition may also occur in children with other chromosome abnormalities. Chromosomes
are the structures in our cells that carry our genes. These types of abnormalities often occur
What are the symptoms of HFM in a child?
Symptoms can occur a bit differently in each child. The deformities caused by HFM
vary. They may range from mild to severe. Different areas of the face may be involved. The
following may be underdeveloped in HFM:
In some babies, other parts of the body may also be affected by HFM.
How is HFM diagnosed in a child?
Geneticists often diagnose HFM. A geneticist is a healthcare provider with special
training to diagnose and treat conditions passed down in families (genetic condition).
Your child’s healthcare provider will look at his or her health history. Your child
will also have an exam. Your child’s healthcare provider may also do imaging tests
to make the diagnosis.
These tests may include:
X-rays of the head. X-rays will show the internal tissues and bones inside of your child’s head.
CT scan. A CT scan shows detailed images of any part of the body. Your child may need a CT
scan of the head. This test will show his or her bones, muscles, and underlying tissue.
How is HFM treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
If your child has severe symptoms, he or she may need several surgeries. In this case,
your child will be checked by a craniofacial anomalies team. This is a group of healthcare
providers who diagnose and treat face defects.
Your child’s treatment may include:
Fixing your child’s lower jaw. This is done using a bone graft taken from your child’s
Using a device to correct your child’s jaw
Having surgeries to fix your child’s external ear, cheeks, or jaw
Removing or correcting the position of your child’s teeth
What are possible complications of HFM in a child?
If your child has a mild defect, he or she may not be at risk for complications. Children
with more severe defects may be more likely to have issues. These can include hearing
loss, eating problems, and trouble with self-image.
How can I help my child live with HFM?
Your child may have hearing loss or eating problems related to HFM. Your child will
need to be under the care of a team of craniofacial anomaly experts. This team may
A craniofacial surgeon who can do jaw surgery and ear reconstruction
An ophthalmologist to diagnose and treat eye and vision issues
An orthodontist to check and treat jaw growth and alignment
An otolaryngologist (ear, nose, and throat specialist) to check hearing loss
A speech therapist to give speech therapy
HFM support groups can help you and your child. Ask your child’s healthcare provider
about support groups in your area.
When should I call my child's healthcare provider?
Call your child’s healthcare provider if your child has any new symptoms. These can
include trouble eating or gaining weight.
Key points about HFM in children
In HFM, one side of your baby’s face is underdeveloped. Your baby is born with this
HFM often happens by chance. Sometimes this condition can run in families.
Children with HFM should be checked by a craniofacial anomalies team.
If your child has severe defects, he or she may need several surgeries to fix them.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.