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Cephalometric Analysis of the Craniofacial Morphology in Patients With Moebius Syndrome

Supplemental Digital Content is available in the text Background: Patients with Moebius syndrome may present a wide range of associated orofacial malformations, however, their craniofacial morphology has not been established via controlled cephalometric studies. Objective: To present our institution's findings in the cephalometric evaluation in patients with Moebius syndrome. Methods: Retrospective, cross-sectional study that included patients with Moebius syndrome over 9 years of age who had lateral cephalometric radiographs. Cephalometric analysis measurements of Ricketts, Steiner, and McNamara were performed. Quantitative data are expressed as mean and standard deviation, and qualitative data are expressed in totals and percentages. Comparative statistics between classic and incomplete Moebius and between patients older and younger than 16 years of age were performed. Results: Twenty-four patients were included (54.2% females), mean age 17.46 ± 8.85 years. Fifteen patients (62.5%) had classic Moebius syndrome, and nine (37.5%) had incomplete Moebius. Sixty-six percent of the patients presented either micrognathia or retrognathia, 95% showed mandibular hypoplasia, and 75% had a skeletal class II. Maxillary height was increased resulting in a vertical growth pattern. Upper and lower incisors tended towards proclination, and upper and lower lips protruded over cephalometric markings, and a long upper lip was evidenced in 41% of the patients. No significant differences were noted when comparing classic and incomplete Moebius syndrome. Patients younger than 16 years of age had significantly larger sella–nasion–A point and sella–nasion–B point angles, and a higher proportion of skeletal class II cases. Conclusions: Patients with Moebius syndrome have a vertical maxillary growth, micro or retrognathia, developing a skeletal class II and lip protrusion.