Congenital anomalies of the facial nerve are uncommon and can have variable etiologies. The commonest anomalies seen are: anomalies related to the Moebius syndrome, anomalies of the second branchial arch (e.g. hemifacial microsomia), trigemino-oculomotor synkinesis, and birth trauma (forceps injury).
Many of the techniques for reconstructing the paralyzed face are similar in the congenital and adult population. The notable difference is that in young patients, due to skin tone and tightness, corneal exposure from poor eye closure is not common. Most of the treatment is therefore directed to smile reconstruction and achieving lower facial symmetry