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Area of Science:

  • Craniofacial surgery
  • Plastic surgery
  • Pediatric surgery

Background:

  • Unilateral oral macrostomia is a craniofacial abnormality.
  • It can occur alone or with other anomalies.
  • Facial nerve involvement is rare, but depressor anguli oris paralysis is an overlooked association.

Purpose of the Study:

  • To report depressor anguli oris paralysis in patients with unilateral oral macrostomia.
  • To illustrate the impact of this paralysis on surgical outcomes and patient expectations.
  • To emphasize preoperative assessment of depressor anguli oris function for surgical planning.

Main Methods:

  • Presentation of two cases of unilateral oral macrostomia.
  • One case included contralateral depressor anguli oris paralysis.
  • Clinical observation of pre-operative and post-operative facial animation.

Main Results:

  • Depressor anguli oris paralysis can be present pre-operatively in oral macrostomia.
  • This paralysis affects post-operative symmetry and patient expectations.
  • Pre-operative detection is crucial for managing outcomes.

Conclusions:

  • Depressor anguli oris paralysis is an important consideration in unilateral oral macrostomia.
  • Assessing this function aids surgical decision-making and expectation management.
  • Further research on EMG and botulinum toxin for DAO paralysis is warranted.