Management of maxillofacial hard and soft tissue discrepancy in Mobius sequence: Clinical report and review of the literature

Background: Mobius sequence implies significant maxillofacial hard and soft tissue anomalies which nevertheless have not been addressed thoroughly in the scientific literature. Objectives: To report a case of complete Mobius sequence and discuss the management of maxillofacial hard and soft tissue anomalies. Patients and methods: A 15-year-old girl with complete Mobius underwent bimaxillary orthognathic surgery, horizontal sliding genioplasty and mentalis muscles reinsertion. Vestibuloplasty and bilateral canthopexy were performed to address lip deficiency and attenuate hypotonic depression of the lower eyelids, respectively. Cheekbone augmentation was achieved with an autologous fat transfer. The authors review the scientific literature and discuss surgical planning for the correction of maxillofacial discrepancy. Results: The patient exhibits significant functional and aesthetic improvement, with excellent integration of the transferred fat and adequate bone healing. Conclusions: Orthognathic bimaxillary surgery combined to soft tissue management can improve aesthetics and orofacial function in Mobius patients, thereby contributing to facilitate social interaction and increase patients' self-esteem. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.