Last updated: 11/24/2009

Birth defects and genetic disorders

About 7%, or 227,500, of the children born each year in the United States are affected by birth defects of the head and face. According to the American Society of Plastic Surgeons, 37,732 procedures...

were performed to repair birth defects in 2001, an increase of 2% over the number of surgeries in 2000.

The demographics of specific birth defects affecting the head and face vary; some are considered rare disorders. Figures for some of the disorders most likely to be treated surgically include:

• Cleft palate. Cleft lip or palate is the fourth most common birth defect affecting American children, one in every 700 newborns. The male:female ratio is 2:1 in children of all races. Asian-American children have a higher than average incidence of cleft palate, while African-American children have a lower than average incidence.
• Down syndrome. Down syndrome is the most common congenital disorder caused by a chromosomal abnormality; it occurs in one in every 900 infants. Children with Down syndrome have facial characteristics that typically include slanted eyes, a flattened nasal bridge, small rounded ears, and a large protruding tongue. There are about 350,000 people in the United States with Down syndrome.
• Treacher Collins syndrome. This congenital disorder is caused by a mutation on human chromosome 5 that can arise spontaneously or be inherited from the parents. The craniofacial abnormalities in Treacher Collins include an abnormally small jaw and airway that can cause breathing problems; the ears may also be malformed or missing. Treacher Collins syndrome affects one in every 10,000 infants.
• Apert and Crouzon syndromes. These two disorders are sometimes grouped together because they are both characterized by craniosynostosis, which is the medical term for premature closing of the sutures (seams) in the bones at the top of the skull. Children with these syndromes have misshapen heads and a sunken-in appearance to the face. They also have breathing problems and malpositioning of the teeth caused by deformed facial bones. Apert syndrome is very rare, affecting only one child in every 150,000. Crouzon syndrome occurs in one out of every 25,000 infants.

Traumatic injuries

Traumatic injuries to the face and head can include blunt trauma, lacerations (tears), and burns. Heat, chemicals, or electricity may cause burns. According to the American Burn Institute, there are 1.1 million burn injuries each year in the United States that are serious enough to require medical treatment. In 2001, 16,879 adults needed plastic surgery to repair burn injuries, while 24,298 required maxillofacial surgery for injuries to the face and jaw.

Prior to the early 1980s, when more rigorous seat belt laws were passed, most severe facial injuries in the United States resulted from automobile accidents. As of 2003, however, 70% of facial injuries treated in urban hospitals are caused by assaults; at least 10% of fractured facial bones in women are the result of domestic violence. Falls cause a significant number of facial injuries in small children and the elderly. Another common source of facial trauma in children is animal bites.

Cancer patients

Cancers of the head and neck affect about 55,000 Americans each year; about 13,000 of these patients die. These cancers include cancers of the skin of the face, the esophagus, the larynx (voice box), the mouth, and the nasal passages. Most of these cancers are preventable because they result from prolonged exposure to either sunlight (facial skin) or tobacco (mouth, throat, nose, and larynx). Men are two to four times as likely to develop cancers of the mouth and throat as women.