Hemifacial Microsomia: Treatment
Early Non-Surgical Treatment:
Ears. If a child is born with an absent ear, which is
called "microtia", then keeping the opposite functional eardrum healthy
takes on an even greater importance. I recommend that parents who have
a child with microtia to be on the lookout for any sign of an ear infection
on the opposite side (it is not really possible to get an ear infection
on the microtic side). Multiple ear infections on the unaffected side
may diminish hearing; therefore, parents should have a low threshold for
bringing their baby to the pediatrician (or pediatric ENT) to check for
possible ear infections.
In general, the vast majority of children with microtia never need any
hearing aids. It is important to have your child's hearing tested periodically.
If both the ears are normal in size, but one side (or both) is prominent
(sticks out), this condition may be treated non-surgically with molding
wax, as long as treatment is begun in the first few weeks of life. After
about 8 weeks of age, molding does not work because the ear cartilage
attains "memory." See the section for more information on ear reconstruction,
or go to the
Section.
Sleep apnea. It is also important to make sure that any
child with hemifacial microsomia does not have sleep apnea. Children born
with an absent TMJ (temporomandibular joint, or jaw joint) may have a
"floppy" lower jaw that can shift backwards when the child is asleep at
night, causing sleep apnea. If your child is a "noisy breather" at night,
it is a good idea to get a sleep study to ensure your child is getting
enough oxygen while asleep in order to continue to develop and learn normally.
For some children, it is possible to use a special orthodontic device
(a "Herbst appliance") to help prevent sleep apnea. Rarely, children may
need to use a special mask (called CPAP or BiPAP units) while sleeping,
which helps the child to get enough oxygen while sleeping. In general,
sleep apnea is not common in hemifacial microsomia, but it is important
to check for in children who are more severely affected.
Speech Evaluation. Some children with hemifacial microsomia
may have an imbalance in the movement of the palate (roof of mouth), which
on rare occasions may lead to abnormal speech. If any asymmetrical
palatal motion is identified, then your child should be evaluated by a
speech pathologist.
Ear
Reconstruction | Jaws
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