title: Orthognathic surgery for the complete rehabilitation of Moebius patients: principles, timing and our experience.
abstract: Moebius syndrome is a rare disorder found in approximately 1/100,000 neonates and the treatment of facial palsy is now well established worldwide and consists of free-muscle transplants reinnervated with motor nerves. Dentofacial deformities are often detected in Moebius patients, and different degrees of micrognathia are often present, particularly in patients with complete expressions of Moebius syndrome. However only two published reports have described the surgical treatment of such anomalies in these patients; in both cases, the suggested approach consisted of orthognathic surgery followed by soft-tissue management. In this paper we discuss the indications and correct timing of orthognathic surgery and suggest to perform facial animation at an early age and then to wait for the completion of maxillofacial skeletal growth before performing orthognathic surgery. Finally, facial animation should precede orthognathic surgery in adult patients to prevent lower lip deformities and to ensure more predictable and satisfactory results.
authors.affiliation: Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Bianchi
authors.forename: A
authors.initials: A
authors.lastname: Ferri
authors.forename: B
authors.initials: B
authors.lastname: Brevi
authors.forename: A
authors.initials: A
authors.lastname: Di Blasio
authors.forename: C
authors.initials: C
authors.lastname: Copelli
authors.forename: C
authors.initials: C
authors.lastname: Di Blasio
authors.forename: A
authors.initials: A
authors.lastname: Barbot
authors.forename: T
authors.initials: T
authors.lastname: Ferri
authors.forename: E
authors.initials: E
authors.lastname: Sesenna
mesh_terms: D002680:Chin / Q000601:surgery; D005149:Facial Expression; D005158:Facial Paralysis / Q000601:surgery; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000294:innervation / Q000637:transplantation; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy; D019186:Mandibular Advancement / Q000379:methods; D008406:Masseter Muscle / Q000294:innervation; D020331:Mobius Syndrome / Q000601:surgery*; D009046:Motor Neurons / Q000637:transplantation; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010155:Palatal Expansion Technique; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult