Magnetic resonance imaging of congenital unilateral hypoplasia of the face

Abstract

Facial asymmetry may originate from abnormalities of facial musculature, facial innervation, Lateral facial dysplasias or otomandibular dysostosis. We describe Magnetic Resonance Imaging findings of congenital unilateral hypoplasia in a teenager. Case Report: A 15 Year old female referred from plastic surgery department for assessment of congenital unilateral asymmetry of face. Data included relevant history and physical examination and the basic diagnostic work up. The child presented with hypoplastic appearance of facial features on the left side compared to the right side. Asymmetry was more pronounced when she smiled and cried. On examination, the face appeared asymmetric at rest. The left hemiface appeared smaller and showed diffuse deficiency of soft tissue compared to the right side. However the overlying skin appeared normal. No neurological deficit was found in nervous system examination. Magnetic resonance imaging findings revealed diffuse reduction of the subcutaneous fat and muscle tissue on the left side. The left orbital, nasal, maxillary, mandibular bones showed hypoplasia. Muscle bulk was reduced on the left side with smaller submandibular and parotid salivary glands. Conclusions: Congenital unilateral hypoplasia of face is a rare anomaly that causes asymmetric of face. Pediatricians and otolaryngologists need to be cognizant of cardiac, head and neck, and central nervous system anomalies associated with congenital unilateral hypoplasia of face. The objective of the treatment is to restore facial symmetry and proper function. Teamwork is essential with a board of members including plastic surgeon, otolaryngologist, orthodontist and prosthodontist.