CONGENITAL HYPOPLASIA OF
THE DEPRESSOR ANGULARIS ORIS MUSCLE (CHDAOM)
IS IT JUST ACOSMETIC
PROBLEM?
Dr. Mohmmad AA
Islamic Hospital, Amman, Jordan
Islamic.Hospital@index.com.jo or fima@index.com.jo
www.islamic-hospital.com.jo
Objectives: To emphasize the importance of correct
diagnosis, to estimate the incidence & to look for associated problems
of CHDAOM, also called Asymmetric Crying Facies.
Method: A prospective study conducted in our pediatric
& neonatal department from Jan. 93 Dec. 2000 (over 8 years) looking for signs of mouth
deviation to one side during crying, laughing or speech, excluding VII
nerve involvement, searching for any minor or major anomalies by performing
complete physical & neurological examination. Several variables were
studied including the (age, sex, gestational age, mode of delivery, birth
weight & the side of the mouth affected).
Results: A total of 24 cases were diagnosed over an
8-year period. The frequency in the neonatal age group is about 0.4/1000
live births. The majority was diagnosed in the early neonatal period (18).
' Male
/Female ratio; 13/11.
' Mode
of delivery: vaginal in 15, vacuum in 5, C.S in 4 cases.
' Birth
weight category: AGA in 16, SGA in 7 & LGA in 1.
'
Full-term in 20 & preterm in 4.
' Left
sided involvement in 19 & right side in 5 !!!
'
Associated congenital heart disease in 1 (ASD); cerebral palsy with
brain
atrophy & seizures in 1, Failure to
thrive in 1 & minor skin lesion in 1.
' Positive family history in 1 case.
Conclusion:
1.
CHDAOM is not rare in children & the best time for its
diagnosis is a
careful physical examination of the
newborn babies.
2. It should
not be confused with facial nerve palsy.
2.
It is mainly a cosmetic problem in the majority of cases but it may
be
associated with other serious congenital
abnormalities.