HYPERTROPHY AND ASYMMETRY OF THE FACIAL-MUSCLES - A PREVIOUSLY UNRECOGNIZED ASSOCIATION

We present 6 patients who do not satisfy the criteria for inclusion in to any known diagnostic group, although they share similar physical fi ndings. All had facial findings suggestive of either mild deformationa l plagiocephaly or craniofacial microsomia; however, hypertrophic and occasionally hyperactive muscles of the face appear to be the unifying and distinctive feature of the group. Contraction of hypertrophic pos tauricular muscles on the affected side resulted in movement and contr action of the pinna. Hypertrophy of the mentalis and masseter muscles was also frequently observed. Additionally, anomalous neck musculature was seen in 4 of the 6 patients. in 2 patients, the hypertrophy of ce rtain of these muscles produced enough deformity to warrant excision. This is the first report of such an association in the literature. Pos sible explanations are discussed.