Craniofacial Microsomia in a Speech Therapy Perspective: A Review of the Literature

Craniofacial microsomia (CFM) is a congenital developmental disorder characterized by asymmetric underdevelopment of structures derived from the first and second pharyngeal arches. It most commonly affects the mandible and the ear, but it is frequently associated with additional anomalies such as cleft palate, vertebral malformations, or velopharyngeal dysfunction (VPD). Due to its complex nature, CFM requires comprehensive diagnostic and therapeutic approaches.

This narrative literature review aimed to characterize articulation difficulties and primary function disorders in patients with CFM, identify their prevalence, and evaluate speech therapy tools used in diagnosis and treatment. A review of 27 articles from PubMed, Scopus, and Cochrane databases was conducted, including case reports, observational studies, and analyses of diagnostic instruments used in clinical practice. Patients with CFM frequently present difficulties in articulation, resonance, voice, and primary functions such as sucking, chewing, and swallowing, along with delays in speech and language development. These issues stem from both anatomical anomalies, such as mandibular hypoplasia and tongue dysmorphology, and functional impairments, including VPD, obstructive sleep apnea, and hearing loss. The literature describes a broad range of compensatory strategies and articulatory distortions, while also indicating limited evidence regarding the effectiveness of available therapeutic tools and interventions.

The findings highlight the importance of an interdisciplinary approach to the diagnosis and speech therapy management of patients with CFM. There is a clear need for further research to assess the effectiveness of therapeutic interventions and to establish unified clinical standards of care.