Congenital Unilateral Lower Lip Paralysis (CULLP) – Symptoms, Diagnosis, and Treatment

Congenital unilateral lower lip paralysis (CULLP), aka asymmetric crying face, refers to a condition that causes one side of a baby’s mouth to remain motionless when he or she cries. It is present at birth and can lead to the development of other medical conditions that cause cardiovascular, neck, face or urinary problems.

Dr. Babak Azizzadeh of The Facial Paralysis Institute is a Harvard-trained and dual board-certified facial plastic and reconstructive surgeon. He takes a holistic approach to CULLP and other forms of facial paralysis. In doing so, Dr. Azizzadeh helps patients achieve their desired treatment results.

What Is Congenital Unilateral Lower Lip Paralysis?

Congenital unilateral lower lip palsy causes a lack of movement on one side of a baby’s face. With CULLP, only one side of a baby’s mouth moves downward as he or she cries. And if the baby’s mouth is relaxed, their face looks symmetrical. 

Is Congenital Unilateral Lower Lip Palsy Common?

Research indicates congenital unilateral lower lip paralysis affects approximately 0.6% of children at birth. These kids also face a higher risk of developing cardiovascular, urinary, and other health issues than others.  

Congenital Unilateral Lower Lip Paralysis Symptoms

There are many symptoms associated with CULLP, such as:

• • Nostrils expand equally when a baby breathes slowly
  • Mouth pulls downward on one side of the face when a baby cries
  • Lips appear thinner on the affected side of the face

When it comes to asymmetric crying face symptoms, it is always better to err on the side of caution. If a parent believes their baby is dealing with CULLP, it is important to seek out medical support. That way, a parent can take the first steps to address his or her baby’s CULLP symptoms.

Lower Lip Paralysis Causes

In some instances, CULLP is caused by facial nerve compression due to birth trauma. Or, in other cases, the condition is linked to the underdevelopment of the lip muscles or similar issues during fetal development.

Testing is available to help a parent identify the root cause of lower lip paralysis in their baby. This testing enables a doctor to find out why the paralysis is occurring and explore treatment options. 

How Is Lower Lip Paralysis Diagnosed?

A doctor can conduct testing to determine if facial weakness in a baby was acquired due to birth trauma or if it is congenital. Initially, the doctor will perform a physical exam. This allows the doctor to assess a baby’s gums and jaw and look for signs of nerve compression. It also enables the doctor to identify other facial anomalies. 

If a doctor believes a baby’s facial weakness is related to a developmental cause, an electromyography (EMG) can be performed. With an EMG, a doctor records electrical activity produced by a baby’s facial muscle cells. He or she also can conduct an ultrasound scanning to produce images from inside the baby’s face. Ultrasounds can be used to verify underdevelopment or obscene of the baby’s depressor anguli oris and depressor labii inferioris muscles. 

Comparatively, if a doctor believes a baby’s facial weakness is congenital, a “FISH” test can be performed for verification. A FISH test involves mapping of genetic material in a baby’s cells. The test allows a doctor to visualize certain genes or portions of genes. In doing so, the test helps a doctor identify any chromosomal abnormalities. 

Extensive testing gives a doctor a starting point for treatment. It ensures that a doctor can accurately diagnose a baby and uncover the best way to address their symptoms and prevent them from becoming ongoing problems. 

Congenital Unilateral Lower Lip Palsy Treatment

The symptoms of congenital unilateral lower lip paralysis often disappear on their own within about a month of onset. They also can become less noticeable as a baby grows. 

If asymmetric crying face symptoms linger, surgery may prove to be a viable option. Sometimes, a myotomy may be used to improve facial symmetry in CULLP patients. Reanimation of the lower lip on the paralyzed side of the face may also help these patients overcome their facial paralysis symptoms.

To date, CULLP surgery has delivered positive outcomes for many patients. It must be performed by a surgeon who understands the intricacies of facial weakness in babies. This surgeon must tailor a surgical procedure to their patient. This ensures the patient can achieve long-lasting treatment results. 

Dr. Azizzadeh’s Approach to Lower Lip Paralysis Treatment

Parents can bring their children to Dr. Azizzadeh for lower lip paralysis treatment. Dr. Azizzadeh has many years of experience in treating children dealing with Bell’s palsy and other forms of facial paralysis. 

For children dealing with lower lip paralysis, Dr. Azizzadeh develops and executes a personalized treatment program. Dr. Azizzadeh takes precautions to protect his patient and deliver the optimal results. And, he ensures that a child and their parents are fully supported over the course of treatment. 

Schedule a Treatment Consultation with Dr. Azizzadeh 

Dr. Azizzadeh assists patients of all ages, and he is happy to treat lower lip paralysis symptoms. To schedule a treatment consultation with Dr. Azizzadeh, please contact us online or call us today at (310) 893-6192.