La paralysie faciale dans les dysplasies oto-mandibulaires. Étude clinique et implications thérapeutiques

Abstract

The percentage of facial palsy in the otomandibular dysostosis is great. It varies from 12 to 50% in the literature. The OMENS classification embodies the muscular and facial nerve defects, and appears to represent the most inclusive classification. Few literature reviews have proposed a treatment of the facial palsy in the otomandibularis dysostosis. The authors proposed a treatment protocol depending on the patient's age. The patients before one year of age are treated with the Iñigo's technique, wich provide reinnervation to the affected muscles through a crossed facial nerve graft. After one-year old, the surgical approach is realised at five to seven years old to permit a physical therapy. The upper lip is reanimated by the lengthening temporalis myoplasty or by free muscle transplantation with nerve graft. The orbital area treatment of the paralysed side can included a lengthening of the upper eyelid levator muscle, an asymetric lateral tarsorraphy and a chondromucous graft.