PubMed · 1069479
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P D Lewis. 1976. The deviated midline.. https://doi.org/10.1016/0002-9416(76)90223-2
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The cause of hemifacial microsomia (HFM) is currently the subject of much investigation. Despite a large body of clinical and experimental data, little is certain other than the heterogeneity of this malformation complex. Here we suggest that some of the cases previously designated as being multifactorial in origin may be interpreted instead as resulting from a single-gene mutation, by applying a stochastic single-gene model. A variety of models of the pathogenesis of HFM have been described, including the proposal that local embryonic haemorrhage is a causal mechanism. More recently, it has been suggested that an interference in chondrogenesis is primarily responsible for the HFM phenotype. In this paper direct experimental evidence, based on surgical interference of mandibular development in the chick embryo, is applied in favour of the latter concept. In particular, asymmetrical perturbation of Meckel's cartilage has been shown to result in asymmetry of the mandible, and it is proposed that, irrespective of cause, the skeletal pathogenesis of HFM primarily involves the auriculofacial cartilage model.
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The dawn of facial asymmetry research dates back to the second half of the last century and started with a discussion about the asymmetry of the face of the Venus of Milo. These early observations revealed some of the lateralized patterns of the two facial halves of which we are now aware. Since these studies have up until now been completely neglected, the present review tries to provide the forgotten beginning of this avenue of lateralization research.