Congenital synkinesis between orbicularis oculi and nasal musculature: is it rare indeed or just underreported?

In this study, demographic data, the incidence among rhinoplasty cases, and treatment approaches of cases diagnosed with congenital ONS in our clinic were discussed.

Facial nerve examinations of 728 patients who applied to our plastic surgery outpatient clinic seeking primary rhinoplasty for cosmetic reasons between January 2015 and January 2019 and nine cases with ONS were included in the study. Family history, sex, age, unilateral or bilateral involvement, accompanying muscles, movement amplitude, accompanying anomalies, and treatment modalities of the subjects were documented.

Among 728 primary rhinoplasty cases who admitted to our clinic, nine patients were diagnosed with ONS. Of these rhinoplasty patients, 76% were female (n 553) and 24% were male (n 175). In the study, the rate of ONS was found to be 0.12% among the patients seeking rhinoplasty. The mean age of the cases was 28.12 years (range 19–47). All patients were female. Eight patients had right-sided ONS, and in one patient, it was located on the left side. No family histories or coexisting anomalies accompanied ONS in any of the patients. The CNMm accompanying the contraction of the OOm muscle was observed during the eye blink in seven cases, dilator naris anterior muscle (DNAm) in one case, and transverse part of nasalis muscle (TNm) in another case.

In the light of the data obtained from this study, we conclude that ONS is fairly common among rhinoplasty cases, and in order to prevent misunderstandings and medico-legal problems, it is essential to recognize this condition before undertaking rhinoplasty, blepharoplasty, or any other surgical procedure.

Level of evidence: Level V, diagnostic study.