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Renault F, Flores-Guevara R, Baudon JJ, Sergent B, Charpillet V, Denoyelle F, Thierry B, Amiel J, Gitiaux C, Vazquez MP. Orofacial motor dysfunction in Moebius syndrome. Dev Med Child Neurol 2020; 62:521-527. [PMID: 31713842 DOI: 10.1111/dmcn.14379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2019] [Indexed: 12/13/2022]
Abstract
AIM To review orofacial disabilities and their consequences in children with Moebius syndrome (MBS). METHOD We retrospectively analysed the records of 32 patients (21 males, 11 females) with non-progressive bilateral facial and abducens palsies who had been examined before 6 months of age. RESULTS All facial muscles were severely involved in 17 patients; in the 15 others, partial movements were found in the lower face. Most patients (n=24) were unable to smile. Patients frequently presented with congenital trismus (n=20) and drooling (n=18). Additional palsies involved cranial nerves IX and X (n=18) and XII (n=25). Sucking was absent or weak in 30 patients; swallowing was impaired in 25. During the first month of life, feeding disorders were graded as severe/moderate in 25. Respiratory complications occurred in 17. Severe feeding disorders were associated with congenital trismus (p=0.01) and with cranial nerve IX and X palsy (p=0.01). Growth failure between 1 and 6 months of age, followed by catch-up growth between 6 and 12 months, was observed in 20 patients. Between 2 and 5 years of age, 25 out of 32 patients attained normal oral diet and 28 out of 29 showed normal growth. INTERPRETATION Children with MBS frequently require adjusted therapeutic options to prevent failure to thrive. Congenital trismus, cranial nerve IX and X palsy, and laryngeal-tracheal dysfunctions are predictors of severe feeding disorders. WHAT THIS PAPER ADDS Moebius syndrome frequently induces reduced oral intake and early failure to thrive. Normal oral diet and growth parameters are attained at 2 to 5 years of age. Congenital trismus, pharyngeal palsy, and laryngeal disorders predict dysphagia.
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Affiliation(s)
- Francis Renault
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France
| | | | | | - Bernard Sergent
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique de l'Enfant, Hôpital Necker-Enfants-Malades, Paris, France
| | - Valérie Charpillet
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique de l'Enfant, Hôpital Necker-Enfants-Malades, Paris, France
| | - Françoise Denoyelle
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service d'Otorhinolaryngologie, Hôpital Necker-Enfants-Malades, Paris, France
| | - Briac Thierry
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service d'Otorhinolaryngologie, Hôpital Necker-Enfants-Malades, Paris, France
| | - Jeanne Amiel
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Département de Génétique, Hôpital Necker-Enfants-Malades, Paris, France
| | - Cyril Gitiaux
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service de Neurophysiologie Clinique Pédiatrique, Hôpital Necker-Enfants-Malades, Paris, France
| | - Marie-Paule Vazquez
- Centre de Référence des Fentes et Malformations Faciales 'MAFACE', Hôpital Necker-Enfants-Malades, Paris, France.,Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique de l'Enfant, Hôpital Necker-Enfants-Malades, Paris, France.,Faculté de Médecine Paris Descartes, Université Paris, Paris, France
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