title: [Cayler syndrome: A case report and review of the literature].
abstract: OBJECTIVE
  Facial asymmetries to the tears are rare. We report a pediatric original case that may fall within the framework of a Cayler syndrome. Through its clinical presentation, we will discuss differential diagnoses, associated forms, its etiology, and its management.
  
  
  METHODS
  At the maternity unit, in a male infant, after vaginal delivery at term without extraction, was discovered a lack of mobility of the labial commissure on the right side, only when crying. The rest of the examination was unremarkable, except ipsilateral microtia. Genetically, karyotype was 46,XY, 22q11 without microdeletion. The head and neck MRI and echocardiogram were normal.
  
  
  CONCLUSIONS
  Asymmetry with tears has been described in the literature, through association with microdeletion 22q11 syndrome. The originality of this case was the presence of an isolated muscle abnormality. Muscles affected by this syndrome are: Musculus depressor labii inferioris, the Depressor anguli oris, and Mentalis musculus. The three muscles can be affected concomitantly. Isolated involvment of the Depressor anguli oris muscle has also been described. The mechanical dysfunction can be either linked to muscle innervation agenesis or to a defect thereof. There is no specific treatment. The symptoms improve with age by decreasing the frequency of crying. However, it is important to know this pathology in order to seek an optimum balance further in search of associated abnormalities (FISH 22q11, cardiac Doppler ultrasound) but also to educate, to reassure families often worried by the situation.
authors.affiliation: Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
authors.forename: J
authors.initials: J
authors.lastname: Bellaiche
authors.affiliation: Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
authors.forename: N
authors.initials: N
authors.lastname: Correia
authors.affiliation: Chirurgie pédiatrique, American Memorial Hospital, 47, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Bouche Pillon Persyn
authors.affiliation: Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
authors.forename: S
authors.initials: S
authors.lastname: Chiriac
authors.affiliation: Chirurgie plastique reconstructrice et esthétique, hospice civil, chirugie B, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Bodin
authors.affiliation: Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France; Chirurgie pédiatrique, American Memorial Hospital, 47, rue Cognacq-Jay, 51092 Reims cedex, France; EA 3801, SFR CAP santé Reims-Amiens, université de Champagne-Ardenne, hématologie, hôpital Robert Debré, rue du Général-Koening, 51100 Reims, France. Electronic address: cfrancois@chu-reims.fr.
authors.forename: C
authors.initials: C
authors.lastname: François
mesh_terms: D002675:Child, Preschool; D003448:Crying / Q000502:physiology*; D005158:Facial Paralysis / Q000503:physiopathology*; D006801:Humans; D008297:Male
keywords: Asymétrie faciale; Cayler syndrome; Chirurgie plastique; Chirurgie pédiatrique; Di George syndrome; Facial asymmetries; Genetic; Génétique; Pediatric; Plastic surgery; Syndrome de Cayler