Understanding the Educational and Social Difficulties in Children with Hemifacial Microsomia – A Literature Review
DOI:
https://doi.org/10.12775/QS.2024.36.56644Keywords
hemifacial microsomia, microtia, psychosocial adjustment, neurocognitiveAbstract
Introduction: Hemifacial microsomia (HFM) is a congenital craniofacial defect, the second most common after cleft lip and palate. It is characterized by a wide range of symptoms, including mandibular hypoplasia, ear anomalies, and soft tissue defects. Patients may experience difficulties in learning, communication, and social relationships, which affect their quality of life and self-esteem. Study aims to evaluate the impact of defect on the neurodevelopmental and psychosocial outcomes in affected children.
Materials and methods: Materials for the review were selected based on an analysis of publications published in the last 20 years.
Results: In HFM patients with microtia, mandibular hypoplasia, young maternal age, and additional developmental anomalies, worse outcomes were observed in verbal, non-verbal, and academic skills. Studies on emotional functioning demonstrated a similar level of behavioral adjustment compared to control groups. Adolescents with HFM exhibited a lower tendency toward aggression and rule-breaking. Social problems, such as less frequent contact with peers or rejection by the group, were more common. This was particularly true for children with microtia and mandibular hypoplasia.
Discussion: New studies emphasize that although some young children initially do not exhibit neurological or language deficits, there is an increased risk of educational and psychosocial difficulties in later life. Attention should be paid to patients with mandibular hypoplasia, microtia, and additional defects. Negative experiences in peer relationships and hearing loss may further adversely affect self-esteem and social functioning.
Conclusions: HFM can affect the neurological and psychosocial development of children, especially in language and educational areas. Early intervention, assessment of psychosocial problems, provision of appropriate educational resources, and psychological support are crucial to improving patients' quality of life.
References
Brandstetter K.A., Patel K.G.: Craniofacial Microsomia. Facial Plast Surg Clin North Am., 2016; 24(4): 495–515. doi: 10.1016/j.fsc.2016.06.006
Collett BR, Speltz ML, Cloonan YK, Leroux BG, Kelly JP, Werler MM. Neurodevelopmental outcomes in children with hemifacial microsomia. Arch Pediatr Adolesc Med. 2011;165(2):134-140. doi:10.1001/archpediatrics.2010.271
Johns AL, Luquetti DV, Heike CL, et al. Parental Reports of Intervention Services and Prevalence of Teasing in a Multinational Craniofacial Microsomia Pediatric Study. J Craniofac Surg. 2021;32(8):2687-2691. doi:10.1097/SCS.0000000000007999
Dufton LM, Speltz ML, Kelly JP, Leroux B, Collett BR, Werler MM. Psychosocial outcomes in children with hemifacial microsomia. J Pediatr Psychol. 2011;36(7):794-805. doi:10.1093/jpepsy/jsq112
Birgfeld C.B., Luquetti D.V., Gougoutas A.J., Bartlett S.P., Low D.W. et al.: A phenotypic assessment tool for craniofacial microsomia. Plast Reconstr Surg., 2011; 127(1): 313–320. doi: 10.1097/PRS.0b013e3181f95d15
Pniak M. Hemifacial microsomia – a review of the literature of current hypotheses of pathogenesis, and possible therapeutic methods. Pol Otorhino Rev. (2024);13(3):1-8. https://doi.org/10.5604/01.3001.0054.7072
Cloonan YK, Kifle Y, Davis S, Speltz ML, Werler MM, Starr JR. Sleep outcomes in children with hemifacial microsomia and controls: A follow-up study. Pediatrics. 2009; 124(2):e313–21.[PubMed: 19651569]
López D.F., Acosta D.M., Rivera D.A., Mejía C.M.: Hemifacial microsomia: treatment alternatives-a systematic review of literature. J Clin Pediatr Dent., 2022; 46(5): 15–30. doi: 10.22514/jocpd.2022.003
Renkema R.W., and the ERN CRANIO Working Group on Craniofacial Micro somia: European Guideline Craniofacial Microsomia. J Craniofac Surg., 2020; 31(Suppl 8): 2385–2484. doi: 10.1097/SCS.0000000000006691.
Bayley N. The Bayley scales of infant and toddler development. 3rd edn. San Antonio, TX: Harcourt Assessment, Inc, 2006
Hsiao YY, Qi CH, Hoy R, Dale PS, Stump GS, Davison MD, Xia Y. Hierarchy and Reliability of the Preschool Language Scales-Fifth Edition: Mokken Scale Analysis. J Speech Lang Hear Res. 2021 Oct 4;64(10):3983-3994. doi: 10.1044/2021_JSLHR-21-00043. Epub 2021 Sep 21. PMID: 34546794; PMCID: PMC9132022
Achenbach, T. M., & Rescorola, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont Research Center for Children, Youth, and Families
Beery, K.; Beery, NA. Beery-Buktenica Developmental Test of Visual-Motor Integration Manual. Minneapolis, MN: NCS Pearson Inc; 2004
Dunn, L.; Dunn, L. Peabody Picture Vocabulary Test–III Manual. Circle Pines, MN: American Guidance Service; 1997
Speltz ML, Kapp-Simon KA, Johns AL, Wallace ER, Collett BR, Magee L, Leroux BG, Luquetti DV, Heike CL. Neurodevelopment of Infants with and without Craniofacial Microsomia. J Pediatr. 2018 Jul;198:226-233.e3. doi: 10.1016/j.jpeds.2018.02.076. Epub 2018 Apr 22. PMID: 29685618; PMCID: PMC6019149
Luquetti D.V., Saltzman B.S., Vivaldi D., Pimenta L.A., Hing A.V. et al.: Evaluation of ICD-9-CM codes for craniofacial microsomia. Birth Defects Res A Clin Mol Teratol., 2012; 94(12): 990–995. doi: 10.1002/bdra.23059
Werler MM, Sheehan JE, Hayes C, Padwa BL, Mitchell AA, Mulliken JB. Demographic and reproductive factors associated with hemifacial microsomia. Cleft Palate Craniofac J. 2004 Sep;41(5):494-50. doi: 10.1597/03-110.1. PMID: 15352870
Wallace ER, Collett BR, Heike CL, Werler MM, Speltz ML. Behavioral-Social Adjustment of Adolescents with Craniofacial Microsomia. Cleft Palate Craniofac J. 2018;55(5):664-675. doi:10.1177/1055665617750488
Snyder H, Pope AW. Psychosocial Adjustment in Children and Adolescents with a Craniofacial Anomaly: Diagnosis-Specific Patterns. The Cleft Palate Craniofacial Journal. 2010;47(3):264-272. doi:10.1597/08-227.1
Johns AL, Wallace ER, Collett BR, et al. Behavioral Adjustment of Preschool Children With and Without Craniofacial Microsomia. Cleft Palate Craniofac J. 2021;58(1):42-53. doi:10.1177/1055665620947987
Luquetti DV, Brajcich MR, Stock NM, Heike CL, Johns AL. Healthcare and psychosocial experiences of individuals with craniofacial microsomia: Patient and caregivers perspectives. Int J Pediatr Otorhinolaryngol. 2018;107:164-175. doi:10.1016/j.ijporl.2018.02.007
Kuu-Karkku L, Suominen A, Svedström-Oristo AL. Craniofacial microsomia - more than a structural malformation. Orthod Craniofac Res. 2023;26(1):117-122. doi:10.1111/ocr.12592
Collett BR, Chapman K, Wallace ER, Kinter SL, Heike CL, Speltz ML, Werler M. Speech, Language, and Communication Skills of Adolescents With Craniofacial Microsomia. Am J Speech Lang Pathol. 2019 Nov 19;28(4):1571-1581. doi: 10.1044/2019_AJSLP-19-0089. Epub 2019 Oct 3. PMID: 31580699; PMCID: PMC7251598
Speltz ML, Wallace ER, Collett BR, Heike CL, Luquetti DV, Werler MM. Intelligence and Academic Achievement of Adolescents with Craniofacial Microsomia. Plast Reconstr Surg. 2017;140(3):571-580. doi:10.1097/PRS.0000000000003584
Birgfeld C, Heike C. Craniofacial microsomia. Seminars in Plastic Surgery. May; 2012 26(2):91–104. [PubMed: 23633936]
Naumann HL, Haberkern CM, Pietila KE, et al. Duration of exposure to cranial vault surgery: Associations with neurodevelopment among children with single-suture craniosynostosis. Pediatric Anesthesia. 2012; 22:1053–1061. [PubMed: 22502768]
DiMaggio C, Sun LS, Li G. Early childhood exposure to anesthesia and risk of developmental and behavioral disorders in a sibling birth cohort. Anesth Analg. 2011; 113(5):1143–1151. [PubMed: 21415431]
Flick RP, Katusic SK, Colligan RC, et al. Cognitive and behavioral outcomes after early exposure to anesthesia and surgery. Pediatrics. 2011; 128(5):e1053–61. [PubMed: 21969289]
Cline JM, Hicks KE, Patel KG. Characterization of facial paresis in hemifacial microsomia. Otolaryngol Head Neck Surg. 2014; 150(2):188–193. [PubMed: 24492209]
Feragen K, Stock N. A longitudinal study of 340 young people with or without a visible difference: The impact of teasing on self-perceptions of appearance and depressive symptoms. Body image. 2016; 16:133–42. [PubMed: 26828822]
Hamilton KV, Ormond KE, Moscarello T, et al. Exploring the Medical and Psychosocial Concerns of Adolescents and Young Adults With Craniofacial Microsomia: A Qualitative Study. Cleft Palate Craniofac J. 2018;55(10):1430-1439. doi:10.1177/1055665618768542
ICHOM Craniofacial Microsomia Data Collection Reference Guide., red. Koudstaal M.J., Dunaway D.J. 2017. [opened 20.11.2024] Available from: https://ichom.org/files/medical-conditions/craniofacial-microsomia/craniofacial-microsomia-reference-guide.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Michał Pniak, Paweł Miklis, Maciej Mawlichanów, Aleksandra Ciesielska, Aleksandra Sieradzka, Krzysztof Szerej, Zofia Czaplińska-Paszek, Alicja Kot, Marta Wojtczak, Natalia Myśliwiec , Adrian Róźycki
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 123
Number of citations: 0
