Acta Scientific Dental Sciences (ISSN: 2581-4893)

Review Article Volume 4 Issue 1

Jaw Winking Syndrome -A Review

Tushar Bandiwadekar*

Department of Oraland Maxillofacial Surgeon, Belagavi, Karnataka, India

*Corresponding Author: Tushar Bandiwadekar, Department of Oraland Maxillofacial Surgeon, Belagavi, Karnataka, India.

Received: December 05, 2019; Published: December 31, 2019



  JWS is a syndrome which is characterized by synkinesis: that is when two or more than two muscles which have independent nerve supply, having simultaneous or coordinated movements. In 1883, Marcus Gunn had described a 15-year-old girl with a rare condition of a type of congenital ptosis that showed an associated motion of winking of the affected eyelid on the movement of the jaw. Hence this syndrome also termed as Marcus Gunn phenomenon or Marcus Gunn jaw winking syndrome. JWS is usually seen unilaterally, but can present bilaterally in rare cases [1-3]. The winking of eyelid may be elicited by opening the mouth, thrusting the jaw to the contralateral side, jaw protrusion, chewing, smiling, or sucking. This wink phenomenon is often discovered early, as the infant is bottle-feeding or breastfeeding.4,5Both the sexes are equally affected with no racial predilection. Incidence of this syndrome is approximately 5% amongst the population [1].

Keywords: Jaw Winking; Autosomal Dominant; Marcus Gunn; Synkinesis



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  2. Cates CA and Tyers AG. "Results of levator excision followed by fascia lata brow suspension in patients with congenital and jaw-winking ptosis”. Orbit 27.2 (2008): 83-89. 
  3. Park DH., et al. “Treatment of the jaw winking syndrome”. Annals of Plastic Surgery 60 (2008): 404-409.
  4. Pratt SG., et al. “The Marcus Gunn phenomenon. A review of 71 cases”. Ophthalmology 91.1 (1984): 27-30. 
  5. Bradley WG and Toone KB. “Synkinetic movements of the eyelid: a case with some unusual mechanisms of paradoxical lid retraction”. Journal of Neurology, Neurosurgery, and Psychiatry 30.6 (1967): 578-579. 
  6. Beard C. Ptosis. 3rd ed. St. Louis: CV Mosby; (1981): 46-49. 
  7. Duke Elder S. “Normal and abnormal development; congenital deformities. In: System of Ophthalmology. Vol 3, pt 2. St. Louis: CV Mosby (1963): 900-905. 
  8. Hepler RS., et al. “Paradoxical synkineticlevator inhibition and excitation. An electromyographic study of unilateral oculopalpebral and bilateral mandibulopalpebral (Marcus Gunn) synkineses in a 74-year-old man”. Archives of Neurology 18.4 (1968): 416-424.
  9. Wartenberg R. “Winking-jaw phenomenon”. Archives of Neurology and Psychiatry 59.6 (1948): 734-753.
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  11. BJOMS.
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  13. Lyness RW., et al. “Histological appearances of the levator palpebrae superioris muscle in the Marcus Gunn phenomenon”. British Journal of Ophthalmology 72.2 (1988): 104-109.
  14. Putterman AM. “Jaw-winking blepharoptosis treated by the Fasanella-Servat procedure”. American Journal of Ophthalmology 75.6 (1973):1016-1022.
  15. Doucet TW and Crawford JS. “The quantification, natural course, and surgical results in 57 eyes with Marcus Gunn (jaw-winking) syndrome”. American Journal of Ophthalmology 92.5 (1981): 702-707.
  16. Bullock JD. “Marcus-Gunn jaw-winking ptosis: classification and surgical management”. Journal of Pediatric Ophthalmology and Strabismus 17.6 (1980): 375-379.
  17. Dillman DB and Anderson RL. “Levator myectomy in synkinetic ptosis”. Archives of Ophthalmology 102.3 (1984): 422-423.
  18. Bowyer JD and Sullivan TJ. “Management of Marcus Gunn jaw winking synkinesis”. Ophthalmic Plastic and Reconstructive Surgery 20.2 (2004):92-98.
  19. Dryden RM., et al. “Levator transposition and frontalis sling procedure in severe unilateral ptosis and the paradoxically innervated levator”. Archives of Ophthalmology 100.3 (1982): 462-464.
  20. Kersten RC., et al. “Unilateral frontalis sling for the surgical correction of unilateral poor-function ptosis”. Ophthalmic Plastic and Reconstructive Surgery 21.6 (2005): 412-416. 
  21. Islam ZU., et al. “Frontalis muscle flap advancement for jaw-winking ptosis”. Ophthalmic Plastic and Reconstructive Surgery 18.5 (2002): 365-369.
  22. Neuhaus RW. “Eyelid suspension with a transposed levator palpebrae superioris muscle”. American Journal of Ophthalmology 100.2 (1985): 308-311.


Citation: Tushar Bandiwadekar. “Jaw Winking Syndrome -A Review".Acta Scientific Dental Sciences 4.1 (2020): 132-135.


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