The Manifestation of Congenital Hypoplasia of the Depressor Anguli Oris: A Case Report of Asymmetric Crying Facies

TL;DR

This case report describes a rare condition in a seven-month-old girl where a facial muscle is underdeveloped, causing a one-sided smile and cry.

Contribution

The paper adds a new clinical case to the understanding of congenital hypoplasia of the depressor anguli oris muscle.

Findings

The patient showed left-sided mouth deviation during smiling and crying since birth.

No generalized facial muscle weakness or systemic abnormalities were observed.

The condition was confirmed as benign with no need for further intervention.

Abstract

Congenital hypoplasia of the depressor anguli oris muscle (CHDAOM) is a relatively uncommon condition that causes asymmetric crying facies (ACF) in newborns. Although it primarily presents as a cosmetic issue, it could have implications in clinical practice. We report a case involving a seven-month-old girl who presented with asymmetric crying and other related clinical features. The patient exhibited lateral deviation of the mouth angle during smiling and crying but showed no additional clinical abnormalities. There were no signs of generalized facial muscle weakness or paralysis. The diagnosis of CHDAOM was confirmed, based on left-sided mouth deviation during smiling and crying, with no systemic manifestations. The parents reported the presence of deviation since birth. The asymmetry was clearly visible upon clinical examination. The clinical signs included the observed facial asymmetry, with no associated abnormal findings in other areas. The patient’s parents were counseled on the benign nature of the condition to alleviate any concerns. The report also includes a discussion of the management approach and addresses embryological considerations related to CHDAOM.

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