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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2014 April;25(1):1-7
Soft tissue facial asymmetry in subjects with Moebius Syndrome: bilateral vs. unilateral palsy
Sforza C. 1, Pisoni L. 1, Codari M. 1, Gandolfini M. 2, Di Blasio A. 2, Ferrario V. F. 1
1 Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Department of Biomedical Sciences for Health, Faculty of Medicine and Surgery, Università degli Studi di Milano, Milan, Italy;
2 Department of Biomedical, Biotechnological and Translational Sciences, S.Bi.Bi.T Università degli Studi di Parma, Parma, Italy
AIM: Moebius syndrome is a congenital, mono- or bilateral palsy of the facial and abducens nerves. We investigated soft tissue facial asymmetry in a group of patients with Moebius syndrome, comparing patients with monolateral palsy with patients with bilateral palsy, and using a set of asymmetry indices that could be employed by clinicians in their daily practice.
METHODS: The three-dimensional characteristics of the facial soft tissues of 16 male and 11 female patients aged 2 to 46 years were obtained by stereophotogrammetry; 18 paired (right and left) facial distances were calculated (ex-ch; n-ex; t-ex; t-sn; go-me; t-go; n-ch; sn-ch; sto-ch), and asymmetry indices computed. Data obtained in 10 patients with a monolateral palsy were compared to those obtained in 17 patients with a bilateral palsy.
RESULTS: In patient with a bilateral facial palsy, all mean asymmetry indices were smaller than 10%. In contrast, the patients with a monolateral palsy had two mean asymmetry indices that were larger than 15%. The nasion-exocanthion (monolateral: 7.53%, SD 4.55; bilateral: 4.13%, SD 2.44) and subnasale-cheilion (monolateral: 15.97%, SD 23.53; bilateral: 3.87%, SD 2.69) asymmetry indices were significantly larger in patients with monolateral than with bilateral palsy (Student’s t, P<0.05). A large intragroup variability was found.
CONCLUSION: Patients with monolateral Moebius syndrome are more asymmetrical than patients with a bilateral syndrome, but not systematically. Patients with a bilateral palsy may possess an asymmetrical facial alteration.