A Case of Congenital Facial Nerve Palsy with Microtia
Life Sciences-Pediatrics
DOI:
https://doi.org/10.22376/ijpbs/lpr.2022.12.5.L78-81Keywords:
Congenital, Facial Nerve Palsy, Microtia, Developmental, Conductive Hearing Loss, Facial Reanimation Surgeries.Abstract
Congenital facial nerve palsy is defined as the presence of seventh cranial nerve palsy at birth or shortly thereafter. It
occurs due to paralysis of muscles of facial expressions. It is mostly developmental or due to birth trauma. It is rare to be born
with unilateral facial nerve palsy with associated ear anomaly, and hence determining the etiology is pivotal in accessing the
prognosis and for selecting the right treatment for better outcome. In this case, a child is born with unilateral left -sided lower
motor neuron type facial palsy, along with left sided microtia with no history of birth trauma or any associated congenital anomalies.
Therefore, it is of developmental origin and does not fit into any syndromic diagnosis with an magnetic resonance imaging brain
showing normal facial nerve anatomy. Child had little improvement in facial expressions with better eye closure with regular
physiotherapy. Facial reanimation surgeries can be done either in preschool or adolescent period depending on the child’s
condition. In this case, the child is being managed conservatively until he is fit enough to perform facial reanimation surgeries.
References
Mahale RR, Mehta A, John AA, Buddaraju K, Shankar AK, Rangasetty S. Newborn with congenital facial palsy and bilateral anotia/atresia of external auditory canal: rare occurrence. J Pediatr Neurosci. 2016;11(3):271-3. doi: 10.4103/1817-1745.193372, PMID 27857806.
Ciorba A, Corazzi V, Conz V, Bianchini C, Aimoni C. Facial nerve paralysis in children. World J Clin Cases. 2015;3(12):973-9. doi: 10.12998/wjcc.v3.i12.973, PMID 26677445.
Lorch M, Teach SJ. Facial nerve palsy: etiology and approach to diagnosis and treatment. Pediatr Emerg Care. 2010;26(10):763-9; quiz 770. doi: 10.1097/PEC.0b013e3181f3bd4a, PMID 20930602.
Gathwala G, Singh J, Dalal P. Congenital facial palsy with bilateral anotia. Indian J Clinpract. 2013;23:628-34.
Zhu YH, Han WJ. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019;54(10):787-91.
Chaudhary S, Injeti G, Taksande A, Meshram R, Lohkare A. Right sided facial nerve palsy, bilateral microtia with polydactyly in an infant – a rare case report. jemds. 2021;10(18):1353-5. doi: 10.14260/jemds/2021/285.
Hamizan AW, Yean KT, Abdullah A. Congenital bilateral facial nerve hypoplasia with sensorineural hearing loss: a case report. Int J Pediatr Otorhinolaryngol. 2012;76(3):455-9. doi: 10.1016/j.ijporl.2012.01.002, PMID 22281372.
Decraene L, Boudewyns A, Venstermans C, Ceulemans B. Developmental unilateral facial palsy in a newborn: six cases and literature review. Eur J Pediatr. 2020;179(3):367-75. doi: 10.1007/s00431-019-03484-8, PMID 31989259.
Lehky T, Joseph R, Toro C, Wu T, Van Ryzin C, Gropman A, et al. Differentiating Moebius syndrome and other congenital facial weakness disorders with electrodiagnostic studies. Muscle Nerve. 2021;63(4):516-24. doi: 10.1002/mus.27159, PMID 33389762.
Yetiser S. Non-traumatic congenital facial nerve paralysis; electroneurophysiologic evaluation of four cases. Int J Pediatr Otorhinolaryngol. 2005;69(10):1419-27. doi: 10.1016/j.ijporl.2005.03.038, PMID 15927271.
Bergstrom L, Baker BB. Syndromes associated with congenital facial paralysis. Otolaryngol Head Neck Surg. 1981;89(2):336-42. doi: 10.1177/019459988108900238, PMID 6787538.
Suutarla S, Rautio J, Ritvanen A, Ala-Mello S, Jero J, Klockars T. Microtia in Finland: comparison of characteristics in different populations. Int J Pediatr Otorhinolaryngol Pediatr Otorhinolaryngol2007. 2007;71(8):1211-7. doi: 10.1016/j.ijporl.2007.04.020, PMID 17548114.
House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146-7. doi: 10.1177/019459988509300202, PMID 3921901.
Webb BD, Manoli I, Engle EC, Jabs EW. A framework for the evaluation of patients with congenital facial weakness. Orphanet J Rare Dis. 2021;16(1):158. doi: 10.1186/s13023-021-01736-1, PMID 33827624.
Deramo PJ, Greives MR, Nguyen PD. Pediatric facial reanimation: an algorithmic approach and systematic review. Arch Plast Surg. 2020;47(5):382-91. doi: 10.5999/aps.2020.00710, PMID 32971589.
Bartel-Friedrich S. Congenital auricular malformations: description of anomalies and syndromes. Facial Plast Surg. 2015;31(6):567-80. doi: 10.1055/s-0035-1568139, PMID 26667631.
Terzis JK, Anesti K. Developmental facial paralysis: a review. J Plast Reconstr Aesthet Surg. 2011;64(10):1318-33. doi: 10.1016/j.bjps.2011.04.015, PMID 21724478.
Banks CA, Hadlock TA. Pediatric facial nerve rehabilitation. Facial Plast Surg Clin North Am. 2014;22(4):487-502. doi: 10.1016/j.fsc.2014.07.006, PMID 25444723.
Gur E, Kedar DJ, Zaretski A, Arad E, Meilik B, Yanko R et al. Facial nerve paralysis - therapeutic approach, facial reanimation and adjunctive treatment. Harefuah. 2020;159(8):612-7. PMID 32852164.
Sasaki M, Imamura Y, Sato N. Magnetic resonance imaging in congenital facial palsy. Brain Dev. 2008r;30(3):206-10. doi: 10.1016/j.braindev.2007.07.014, PMID 17869466.
Bafna RK, Lata S, Sachan A. A rare case of congenital facial nerve palsy with extreme ocular manifestations.BMJ Case Reports CP. 2021;14:242540.
Nagehan A, Cigdem S, Ahmet RO, MD. The differential diagnosis of a patient with unilateral congenital facial paralysis: 3q21 deletion. Acad J PedNeonatol. 2018;6(3):555743.
Published
How to Cite
Issue
Section
Copyright (c) 2022 S. Sundari, R. Srinithi

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.