Arnaud E, Marchac D, Renier D
Unité de chirurgie crânio-faciale, service de neurochirurgie pédiatrique, hôpital Necker-Enfants Malades, 149-161, rue de Sèvres, 75743 Paris, France.
Ann Chir Plast Esthet. 2001 Oct;46(5):410-23. doi: 10.1016/s0294-1260(01)00055-3.
Craniofacial asymmetry is caused by various aetiologies but clinical examination remains the most important criteria since minor asymmetry is always present. The diagnosis can be confirmed by anthropometric measurements and radiological examinations but only severe asymmetries or asymmetries with an associated functional impairment should be treated. The treatment depends on the cause, and on the time of appearance. Congenital asymmetries might be treated early, during the first year of life if a craniosynostosis is present. Hemifacial microsomia are treated later if there is no breathing impairment. Since the pediatricians have recommended the dorsal position for infant sleeping, an increasing number of posterior flattening of the skull has been appearing, and could be prevented by adequate nursing. Other causes of craniofacial asymmetries are rare and should be adapted to the cause (tumors, atrophies, neurological paralysis, hypertrophies) by a specialized multidisciplinar team.