Hemifacial Microsomia and/or Goldenhar Syndrome:
Some Questions and Answers
Q. What is the
difference between Hemifacial Microsomia and Goldenhar?
A. Both are a condition in which one side of the face is
smaller than the other. Goldenhar will also include issues involving the eye and the
spine. Both will include the jaw, ear and facial bony structures.
Q. What caused my child to have this condition?
A. The exact causes of Hemifacial Microsomia and Goldenhar are
largely unknown, although due to the sporadic nature of occurrence, it is theorized that
some sort of in-utero trauma or exposure may have led to this condition. There is also some
minimal evidence that there may be a weak genetic link.
Q. When can they fix the asymmetry
of the face?
A. There is some controversy concerning the optimal time of
surgical intervention. However, the recommendation by most craniofacial teams at
present is to consider an early surgical correction, with distraction osteogenesis
treatment as early as age 2.
Q. What do they look for, physically, to
make a diagnosis of hemifacial microsomia?
A. A child with hemifacial microsomia or Goldenhar will
have a difference in size between the two sides of the face -- a small jaw, smaller on one
side than the other, microtia in one ear, and ear tags. The asymmetry
of the face
may become more pronounced as the child gets older.
Q. Will my child be mentally retarded?
A. Probably not. Neither Hemifacial Microsomia nor Goldenhar
Syndrome show mental retardation to be a marker.
Q. Will my child be likely to pass this
condition on to my grandchildren?
A. Most likely - no. Hemifacial Microsomia and Goldenhar
seem to occur sporadically at a rate of /3,500 - 1/5,000. There is some evidence of
a weak genetic link, but most believe it be more environmentally caused.
Q. Is it still Hemifacial
Microsomia if both sides of my child's face seem to be affected?
A. Yes. In fact, in approximately 15% of children
with hHmifacial Microsomia, both sides of the face were affected -- although the two sides
were not affected equally.