What Is Craniofacial Microsomia?

Craniofacial microsomia is the spectrum of abnormalities that mainly affect the development of the skull and face before a child is born. Smallness of the skull and certain facial structures characterize the features of this disorder.

Facial asymmetry, a condition that leads to differences in the size and shape of facial structures between the right and left sides of a child’s face, is a common feature of craniofacial microsomia. In many cases, abnormalities that affect both sides of the face are present, however, others are affected on only one side of the face.

Craniofacial microsomia tends to primarily affect the ear and jaw structures, though other conditions that affect the eyes, spinal bones and heart may also be present. Sometimes craniofacial microsomia may be also be referred to differently, depending on a specific diagnosis. For instance, hemifacial microsomia may be used when maxillary or mandibular hypoplasia is also present.

What Causes Craniofacial Microsomia?

Medical researchers and doctors are still not certain what causes this condition. Craniofacial microsomia develops in a fetus during the first three months of pregnancy. While the cause remains uncertain, the condition appears to arise due to a lack of blood flow to the face during fetal development.

Though couples who have had a child with this condition have a small chance of recurrence with another child, craniofacial microsomia does not appear to be an inherited condition.

What Are the Features of Craniofacial Microsomia?

This disorder is characterized by underdeveloped facial features in a child. It’s common for this condition to only affect one side of a child’s face. Aside from the effects of these underdeveloped facial structures, most children with craniofacial microsomia do not have other significant health problems.

Craniofacial microsomia primarily affects the jaws and ears of children. Some of the features of this condition include:

  • An abnormally small or missing ear
  • No ear canal
  • Facial skin tags
  • Other ear and cheek deformities
  • An abnormally wide or small mouth
  • Cleft lip and palate
  • A small or crooked lower jaw
  • Facial palsy
  • An opaque growth on the eye called epibulbar dermoid

What Are the Treatments for Craniofacial Microsomia?

The methods used to treat a child for craniofacial microsomia depend on what parts of their skull and face are affected and the severity of the underdevelopment. Your child’s doctor, along with a team of craniofacial specialists, will create a list of options and treatment plan for your child.

A small jaw or cleft palate due to craniofacial microsomia may cause difficulty with breathing and feeding in some infants with this condition. Breathing problems are typically alleviated with the use of positioning devices, tubes and jaw advancement procedures.


Surgery is typically used to correct developmental abnormalities in a child’s ears. However, doctors will typically wait until a child is between 6 and 8 years old to allow their ears to approach their adult size before performing the surgery.

Jaw Advancement

Depending on the severity of the underdevelopment in a child’s jaw, surgery is often necessary. Distraction osteogenesis is a surgical procedure that involves using a device implanted in a child’s jaw to gradually move it forward. This procedure helps to open a baby’s airways as well as aid in the jaw’s development.


Tissue grafting is a common solution for cases for underdeveloped cheekbones. Implants may be synthetic or come from the child’s own body tissue. Craniofacial surgeons typically perform this procedure when a child is around 10 years old.