Surgical techniques for smile restoration in patients with Mobius syndrome

M Morales-Chavez,F Suarez-Gorrin,Ma Ortiz-Rincones

doi:10.4317/jced.51116

Abstract

Möbius syndrome is a congenital condition, the etiology when is not associated with misoprostol is not well defined. Signs and symptoms include difficulty swallowing, speech problems, drooling, strabismus, limitation of eye movement and more importantly, the facial blankness that these individuals have, result of the facial paralysis, due to atrophy of the cranial nerves that are involved in this condition. The ability to express emotions is affected and are considered “children without a smile.” There is currently no treatment to solvent the birth defects, the treatment options for reduce these alterations is the surgical option that has as main objective to restore muscle function through various techniques, used as required, the possibilities of applying them, is taking into consideration the outcome of the procedure to execute. Among the surgical techniques used mainly: the lengthening myoplasty of the temporal muscle,muscle transfers, cross-facial grafting, neurorrhaphy and nerve transposition, of which latter are the best performers, giving the patient a more natural, in as far as regards expression and function. Key words:Möbius syndrome, surgery, smile, facial nerve, muscle transfer, transfer nerve, temporalis muscle.

Highlights

The Möbius syndrome (MS) was first described in 1880 by von Graefe and Saemisch, and in a more complete fashion in 1888
The Möbius Syndrome is a rare syndrome, with a 1/150 000 prevalence, that allows for different microsurgical and non-microsurgical techniques to correct the facial paralysis, and the strabismus of the patients
Since it is not always possible to perform microsurgical techniques on all patients, muscle transfer is a good alternative, whether it is of the gracilis muscle, the masseter, or the temporal muscle, as long as a vascularized muscle transfer is made, and that allows for the innervation with the facial nerve, so as to obtain a more natural smile

Summary

Introduction

The Möbius syndrome (MS) was first described in 1880 by von Graefe and Saemisch, and in a more complete fashion in 1888. MS can be classified as classic MS, characterized by facial paralysis (60% of the cases); and as MS associated to other anomalies, whether they are other syndromes, disorders, or affectations of other nerves (40%) [2].

Results

Conclusion