Evaluating International Diagnostic, Screening, and Monitoring Practices for Craniofacial Microsomia and Microtia: A Survey Study

Elsa M. Ronde, Jitske W. Nolte, Frea H. Kruisinga, Saskia M. Maas, Oren Lapid, Fenna A. Ebbens, Alfred G. Becking, Corstiaan C. Breugem

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objectives : To (1) appraise current international classification and clinical management strategies for craniofacial microsomia (CFM) and microtia, and (2) to assess agreement with the European Reference Network “European Guideline Craniofacial Microsomia” recommendations on screening and monitoring. Design : This was a cross-sectional online survey study. The survey consisted of 44 questions on demographics, diagnostics and classification, obstructive sleep apnea, feeding difficulties, speech and language development, hearing, ocular abnormalities, visual development, orthodontic screening, genetic counselling, psychological wellbeing, and extracraniofacial anomalies. Participants : Respondents were participants of 3 international cleft and craniofacial conferences, members of the American Cleft Palate and Craniofacial Association and members of the International Society for Auricular Reconstruction. Respondents were requested to complete 1 questionnaire per multidisciplinary team. Results : Fifty-seven responses were received from 30 countries (response rate ∼3%).The International Consortium for Health Outcomes Measurement diagnostic criteria were used by 86% of respondents, though 65% considered isolated microtia a mild form of CFM. The Orbit, Mandible, Ear, Facial Nerve and Soft Tissue classification system was used by 74% of respondents. Agreement with standardized screening and monitoring recommendations was between 61% and 97%. A majority of respondents agreed with screening for extracraniofacial anomalies (63%-68%) and with genetic counselling (81%). Conclusions : This survey did not reveal consistent agreement on the diagnostic criteria for CFM. Respondents mostly supported management recommendations, but frequently disagreed with the standardization of care. Future studies could focus on working towards international consensus on diagnostic criteria, and exploring internationally feasible management strategies.

Original languageEnglish
Pages (from-to)1118-1127
Number of pages10
JournalCleft Palate-Craniofacial Journal
Issue number9
StatePublished - 1 Sep 2023
Externally publishedYes


  • clinical management
  • clinician survey
  • craniofacial microsomia
  • diagnostics
  • microtia
  • screening

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology


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