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RecruitingNCT07802639Updated Sep 28, 2026

Treatment for "Asymmetric Crying Facies"

An interventional study of Botulinium toxin type A injection in Hemifacial Microsomia and Facial Nerve Paralysis, sponsored by Xiaolei Jin. Recruiting at 1 site in China. Open to participants aged 5 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-09-28.

Sponsored by Xiaolei Jin · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2026; still recruiting 3 months later.
Updated Sep 28, 2026Sponsor changed1 site added+1 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
5 Years to 18 Years
Sex
All
01

Study summary

This study focuses on children with hemifacial microsomia (HFM), a common congenital craniofacial deformity caused by abnormal development of the first and second branchial arches. Up to 45% of children with HFM have facial nerve dysplasia, most frequently involving the mandibular marginal branch. These children present with asymmetric lower-lip movement called "crooked-mouth smile" during smiling, speaking or crying. Unlike asymmetric crying syndrome, this condition does not resolve spontaneously and may gradually get worse.

"Crooked-mouth smile" results from muscle weakness of the lower lip on the affected side, leading to dynamic perioral muscle imbalance. Static treatment includes botulinum toxin injection, muscle resection, nerve cutting and fascia suspension; dynamic treatment includes muscle transfer procedures. Early intervention is important for children's psychological well-being. Botulinum toxin injection is minimally invasive, safe and reversible, and is regarded as a preferred initial therapy. However, prospective clinical evidence regarding its efficacy, safety and appropriate dosage in this pediatric population remains insufficient. This prospective study aims to explore the safety, effectiveness and optimal dose of botulinum toxin injection for treating "crooked-mouth smile" in children with HFM and mandibular marginal branch dysplasia.

02

Conditions studied

  • Hemifacial Microsomia
  • Facial Nerve Paralysis

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Keywords

  • Hemifacial microsomia
  • Botulinum toxin
  • Facial nerve dysplasia
  • Crooked-mouth smile
03

In context

Bell Palsy

85 studies on the registry are indexed under Bell Palsy; 30 are open to participants now.

This study's planned enrollment of 60 is above the median of 42 across 70 interventional studies indexed under Bell Palsy.

Browse Bell Palsy studies →

Lead sponsor

This is the only study on the registry with Xiaolei Jin as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
5 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Children under 18 years old diagnosed with hemifacial microsomia (HFM) and lower-lip asymmetry, with congenital injury of the marginal mandibular branch of the facial nerve, presenting with lower-lip movement disorder and lower-lip asymmetry during smiling and teeth-baring.
  2. Subjects who are able to comply with study protocols and visit schedules.
  3. Subjects whose guardians provide voluntary written .

Exclusion criteria

Exclusion Criteria:

  1. Any disease affecting neuromuscular function, including but not limited to neuromuscular junction disorders such as myasthenia gravis and Lambert-Eaton syndrome, peripheral motor nerve diseases such as amyotrophic lateral sclerosis, or a past medical history of the above-mentioned diseases.
  2. Receiving treatment with any of the following medications:

    1. Within 4 weeks prior to screening: muscle relaxants (tubocurarine chloride, dantrolene sodium, baclofen, etc.), aminoglycosides, polypeptide antibiotics, spectinomycin hydrochloride, tetracyclines, lincomycin, anticholinergic agents (butylscopolamine bromide, trihexyphenidyl hydrochloride, etc.), benzodiazepines, and other drugs that may inhibit neuromuscular transmission or interfere with the effect of botulinum toxin.
    2. Anticoagulants or anti- agents used within 7 days before study drug administration.
  3. Cutaneous abnormalities at the treatment site, including local infection (e.g., herpes simplex, acne, erysipelas), scars, hypertrophic scars, or keloid predisposition.
  4. Prior perioral treatment within 1-year interval before this study.
  5. History of ; known allergy to any component of the or comparator product, or known sensitivity to complex protein components (including botulinum toxin type A, human albumin, gelatin protein, lactose, sodium chloride, or sodium succinate).
  6. Presence of other comorbidities that render the subject inappropriate for enrollment at the investigator's discretion. Eligibility shall be determined by the investigator.
  7. Participation in another clinical trial (drug or device-related) at the time of screening, or participation in any other clinical trial within 30 days before screening.
  8. Subjects unable to communicate or incapable of following study instructions.
  9. Staff members of the study department or sponsor.
  10. Subjects considered unsuitable for participation in this study by the investigator.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

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Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Intervention Group

    Participants receive botulinum toxin injection immediately after enrollment for correction of crooke

    Procedure: Botulinium toxin type A injection

  • Active comparator
    Control Group (Delayed Treatment)

    articipants do not receive botulinum toxin injection at baseline. After completing 6-month follow-up assessment for primary outcomes, subjects in this group will receive botulinum toxin injection.

    Procedure: Botulinium toxin type A injection

Interventions

  • ProcedureBotulinium toxin type A injection

    Injection targets the "depressor labii inferioris" and "depressor anguli oris" for correction of crooked-mouth smile.

06

What researchers measure

Primary outcomes

  1. mouth asymmetry

    A coordinate system is established based on the palpebral fissure and nasion. The sagittal distance differences at the hemilabial midpoint and oral commissure point are evaluated under static, broad-smile, and teeth-baring conditions in children

    Time frame: 1、3、6 months

Secondary outcomes

  1. satisfaction with lips

    Face-Q: satisfaction with lips. FACE-Q Aesthetics: Satisfaction with Lips scale. Patient-reported satisfaction with lip appearance. Rasch-transformed scores range from 0 to 100; higher scores indicate greater satisfaction (better outcome).

    Time frame: 1、3、6 months

  2. Terzis aesthetic and functional grading system for the depressor muscle

    Investigator-assessed depressor muscle aesthetic and functional performance using the Terzis aesthetic and functional grading system for the depressor muscle. Scores range from 0 (Poor, total paralysis) to 2 (Excellent, normal symmetric lower-lip movement); higher scores indicate better aesthetic and functional outcomes.

    Time frame: 1、3、6 months

  3. Smile Improvement Score

    Investigator-assessed improvement in smile aesthetics using the Smile Improvement Score (SIS), a subjective grading system for lip posture during smile. Frontal smile photographs are compared with baseline; scores range from 0(no improvement) to 3 (excellent improvement, symmetric smile); higher scores indicate better smile outcome.

    Time frame: 1、3、6 months

07

Study locations

1 of 1 sites recruiting
  • Plastic Surgery Hospital & Chinese Academy Of Medical Sciences
    Beijing, China
    Recruiting
    • Xiaoshuang Guo, M.D. · Contactgxsinjnu@126.com · 86-13121234163
    • Xiaoshuang Guo, M.D. · Principal investigator
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Sites
1 site added, 1 site removed
Show site
  • Plastic Surgery Hospital & Chinese Academy Of Medical Sciences · Beijing, China
Show 1 removed
  • Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College · Beijing, China
Sep 28, 2026
Sponsor
Peking Union Medical College→Xiaolei Jin
Sep 28, 2026
Show all 1 update
  1. Sep 28, 2026
    1 site added, 1 site removed
    Show site
    • Plastic Surgery Hospital & Chinese Academy Of Medical Sciences · Beijing, China
    Show 1 removed
    • Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College · Beijing, China
    Sponsor Peking Union Medical College→Xiaolei Jin

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07802639
Lead sponsor
Xiaolei Jin
Responsible party
Xiaolei Jin (Head of craniomaxillofacial department, Peking Union Medical College) — Sponsor-investigator
First posted
Sep 3, 2026
Start date
Aug 7, 2026
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2029 (estimated)
Last update
Sep 28, 2026

Study contacts

Xiaoshuang Guo, M.D.
Contact
gxsinjnu@126.com
+86 13121234163

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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