Myoplasty for congenital macrostomia

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Surgery

Background:

• Congenital macrostomia presents unique challenges in commissural reconstruction.
• Existing literature lacks a standardized classification and comprehensive description of advanced myoplasty techniques for extensive macrostomia.

Purpose of the Study:

• To describe and evaluate different myoplasty techniques for limited and extensive congenital macrostomia reconstruction.
• To propose a surgical classification for congenital macrostomia based on required myoplasty.

Main Methods:

• Retrospective analysis of twelve congenital macrostomia cases.
• Surgical procedures included orbicular myoplasty, with masseteric myoplasty or pharyngoplasty for extended clefts.
• Evaluation of functional (phonation, expression, deglutition) and aesthetic results.

Main Results:

• Excellent functional outcomes were achieved, including normal phonation, facial expression, and deglutition.
• Good aesthetic results were observed, with minimal complications like skin fasciculation.
• Extended clefts required more complex myoplasty techniques for successful reconstruction.

Conclusions:

• Myoplasty techniques for macrostomia should be tailored to cleft extent, ranging from simple orbicular reorientation to complex masseteric or pharyngoplasty.
• A novel surgical classification for congenital macrostomia is proposed, correlating cleft extension with necessary myoplasty.
• These advanced techniques and classification address rare but complex cases not fully covered in current literature.