What is the role of congenital unilateral lower lip paralysis (CULLP) in the etiology of congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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This is not usually considered a true congenital facial paralysis, but these patients present with drooping of the lower lip toward the unaffected side when laughing or crying and normal appearance of the face at rest. Congenital unilateral lower lip paralysis (CULLP) can appear in clusters with cardiac anomalies, which should provoke an evaluation for VCFS. The etiology of CULLP is most often attributed to hypoplasia or congenital absence of the depressor anguli oris or the depressor labii inferioris muscle. A second theory proposes that a primary brainstem infarction occurs and causes secondary hypoplasia of the musculature. [7, 28, 29] Almost 10% (9.4%) of cases are associated with major malformations, most commonly heart defects. Many of those patients with the cardio facial syndrome have the 22q11.2 deletion. Chromosomal analysis for these patients is recommended. [26]

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