Asymmetric Crying Facies: Which Is the `Right-Wrong' Side?
1 Children's Hospital of the City of Cologne (Director Prof Dr H. Ewerbeck), Amsterdamerstr 59, 5000 Köln 60, Federal Republic of Germany
To the Editor.
Congenital asymmetric crying facies is generally considered to be due to unilateral agenesis or hypoplasia of the anguli oris depressor muscle (HAODM). Electromyographic (EMG) examinations of the affected sides have revealed absent spontaneous activity or diminished motor unit activity.1-3 Association of HAODM syndrome with congenital heart disease, the "cardiofacial syndrome," has been described.4 Major defects of other organ systems and minor congenital defects may be associated with asymmetric crying facies as well.5
Monreal6 reported five patients with asymmetric congenital crying facies syndroms who besides this anomaly displayed juxtaoral defects, egm atresia of one side of the jaw and soft palate, cleft lip, hypoplasis of mandible and ear.




