Congenital microtia complicated by congenital facial palsy; A report of four cases.

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Clinical findings were evaluated in 4 cases of congenital microtia complicated by congenital facial palsy. Cases 1 and 2 were representative of atypical microtia with a fistula originating from the first branchial fissure and stenosis of the external auditory canals. Cases 3 and 4 presented with a nearly normal morphology in ears of mildly decreased size. No fistulae were present. The external auditory canal was occluded near the junction of the osseous and cartilagenous sections.Facial palsy was incomplete in all patients. It was most dramatic at the forehead and lower lip.Tear secretion was normal in 3 cases.Taste sensation was decreased in 3 cases in areas innervated by the chorda tympani. The areas innervated by the glossopharyngeal and major pyramidal nerves exhibited normal taste sensation in all the cascs.The following 4 factors were suggested as the causes of paralysis.Developmental abnormalities of the external and middle ear.Developmental abnormalities of the facial nerve within the temporal bone.Developmental abnormalities in the facial bones and the associated muscles of facial expression.Decreased distribution of collaterals from peripheral branches of the facial nerve.