Ramus marginalis mandibulae nervus facialis palsy in hemifacial microsomia

Authors:

ABSTRACT

Aim

The paralysis of the ramus marginalis mandibulae nervus facialis may occur in Hemifacial Microsomia (HM); the
combination of both HM and palsy contributes to an elongation of the mandibular body. This study explores a possible correlation
between neurological deficit, muscular atony, and structural deficiency. STUDY DESIGN: Of 58 patients with HM who had come to the
University of Rome (Sapienza) Pre-surgical Orthodontics Unit, 4 patients were afflicted with Hemifacial Microsomia and ramus
marginalis mandibulae nervus palsy; these patients unserwent physical, neurological, opthamologic and systemic examinations. The
results were then analysed in order to determine a possible correlation between neuro-muscular and structural deficit.

Methods

Electroneurographic and electromyographic examinations were performed to estimate facial nerve and muscles
involvement.

Results

Neuroelectrographic exam showed a damage of the nervous motor fibres of the facial nerve ipsilateral to HM,
with an associated damage of the muscular function, while neuro-muscular functions on the healthy side were normal. CONCLUSIONS:
The peripheral nervous and muscular deficits affect the function of facial soft tissues and the growth of mandibular body with an
asymmetry characterised by a hypodevelopment of the ramus (due to the HM) and by an elongation of the mandibular body (due to
ramus marginalis mandibulae nerve palsy), so that the chin deviation is contralateral to HM. In these forms, a neurological examination
is necessary to assess the neurological damage on the HM side. Neuromuscular deficiency can also contribute to a relapse tendency
after a surgical-orthodontic treatment.

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