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Thomas MA, Bedard T, Crawford S, Lowry RB. Prenatal findings in 11 cases with craniofacial microsomia using the Alberta Congenital Anomalies Surveillance System, 1997-2019. Am J Med Genet A 2024; 194:e63594. [PMID: 38553895 DOI: 10.1002/ajmg.a.63594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 07/05/2024]
Abstract
Craniofacial microsomia (CFM) primarily includes specific head and neck anomalies that co-occur more frequently than expected. The anomalies are usually asymmetric and affect craniofacial features; however, there are frequently additional anomalies of variable severity. Published prenatal findings for CFM are limited. This study contributes 11 cases with CFM and their anomalies identified prenatally. Cases born between January 1, 1997 and December 31, 2019 with CFM were abstracted from the Alberta Congenital Anomalies Surveillance System, which is a population-based program ascertaining congenital anomalies for livebirths, stillbirths, and termination of pregnancies for fetal anomalies. There were 11 cases ascertained with prenatal findings including facial anomalies: one each with left cleft lip, right microtia, and bilateral microphthalmia. Two cases had vertebral anomalies. In addition, anomalies of the kidneys, brain, heart, and radial ray were identified. Six (55%) had a single umbilical artery, five (45%) were small for gestational age, and three (27%) were from a twin pregnancy that were discordant for anomalies. Four (36%) overlapped another proposed recurrent constellations of embryonic malformation condition. This study describes prenatal findings for 11 cases with CFM. Comparable to prior published cases, there were recurring anomalies on prenatal imaging, including anomalies of the brain, eye, heart, kidneys, and radial ray, which may aid in the prenatal diagnosis of CFM.
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Affiliation(s)
- Mary Ann Thomas
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanya Bedard
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
| | - Susan Crawford
- Alberta Perinatal Health Program, Alberta Health Services, Calgary, Alberta, Canada
| | - R Brian Lowry
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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2
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Schraw JM, Benjamin RH, Shumate CJ, Canfield MA, Scott DA, McLean SD, Northrup H, Scheuerle AE, Schaaf CP, Ray JW, Chen H, Agopian A, Lupo PJ. Patterns of co-occurring birth defects in children with anotia and microtia. Am J Med Genet A 2023; 191:805-812. [PMID: 36541232 PMCID: PMC9928897 DOI: 10.1002/ajmg.a.63081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Many infants with anotia or microtia (A/M) have co-occurring birth defects, although few receive syndromic diagnoses in the perinatal period. Evaluation of co-occurring birth defects in children with A/M could identify patterns indicative of undiagnosed/unrecognized syndromes. We obtained information on co-occurring birth defects among infants with A/M for delivery years 1999-2014 from the Texas Birth Defects Registry. We calculated observed-to-expected ratios (OER) to identify birth defect combinations that occurred more often than expected by chance. We excluded children diagnosed with genetic or chromosomal syndromes from analyses. Birth defects and syndromes/associations diagnosed ≤1 year of age were considered. We identified 1310 infants with non-syndromic A/M, of whom 38% (N = 492) were diagnosed with co-occurring major defects. Top combinations included: hydrocephalus, ventricular septal defect, and spinal anomalies (OER 58.4); microphthalmia and anomalies of the aorta (OER 55.4); and cleft lip with or without cleft palate and rib or sternum anomalies (OER 32.8). Some combinations observed in our study may represent undiagnosed/atypical presentations of known A/M associations or syndromes, or novel syndromes yet to be described in the literature. Careful evaluation of infants with multiple birth defects including A/M is warranted to identify individuals with potential genetic or chromosomal syndromes.
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Affiliation(s)
- Jeremy M. Schraw
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Renata H. Benjamin
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX USA
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX USA
| | - Daryl A. Scott
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX USA
| | - Scott D. McLean
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Hope Northrup
- Department of Pediatrics, Division of Medical Genetics, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX USA
- Children’s Memorial Hermann Hospital, Houston, TX USA
| | - Angela E. Scheuerle
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX USA
| | | | - Joseph W. Ray
- Department of Pediatrics, Division of Medical Genetics and Metabolism, University of Texas Medical Branch, Galveston, TX USA
| | - Han Chen
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
- Center for Precision Health, School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX USA
| | - A.J. Agopian
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX USA
| | - Philip J. Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
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Garel C, Vande Perre S, Guilbaud L, Soupre V, Blondiaux E, Ducou le Pointe H. Contribution of computed tomography and magnetic resonance imaging in the analysis of fetal craniofacial malformations. Pediatr Radiol 2021; 51:1917-1928. [PMID: 33852025 DOI: 10.1007/s00247-021-05033-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/15/2020] [Accepted: 02/21/2021] [Indexed: 11/26/2022]
Abstract
A wide range of craniofacial malformations can be diagnosed in utero using ultrasonography. However, even with highly experienced sonographers and diagnostic physicians and optimal conditions of examination, some anatomical structures cannot be properly analyzed by this technique. The aim of this pictorial essay is to show the additional value of fetal magnetic resonance imaging and computed tomography in this setting and to illustrate the role of these modalities in facial clefts; craniosynostosis; ear, eye and nose abnormalities; otomandibular dysplasias; and facial cephaloceles.
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Affiliation(s)
- Catherine Garel
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France.
| | - Saskia Vande Perre
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
| | - Lucie Guilbaud
- Service de Médecine Fœtale, Hôpital d´Enfants Armand-Trousseau APHP, Sorbonne Université, Paris, France
| | - Véronique Soupre
- Service de Chirurgie Maxillo-faciale et Chirurgie Plastique, Hôpital Necker Enfants-Malades APHP, Paris, France
- Centre de référence Fentes et Malformations Faciales, APHP, Paris, France
| | - Eléonore Blondiaux
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
| | - Hubert Ducou le Pointe
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
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4
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Petracchi F, Sisterna S, Igarzabal L, Wilkins-Haug L. Fetal cardiac abnormalities: Genetic etiologies to be considered. Prenat Diagn 2019; 39:758-780. [PMID: 31087396 DOI: 10.1002/pd.5480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/16/2019] [Accepted: 04/27/2019] [Indexed: 12/21/2022]
Abstract
Congenital heart diseases are a common prenatal finding. The prenatal identification of an associated genetic syndrome or a major extracardiac anomaly helps to understand the etiopathogenic diagnosis. Besides, it also assesses the prognosis, management, and familial recurrence risk while strongly influences parental decision to choose termination of pregnancy or postnatal care. This review article describes the most common genetic diagnoses associated with a prenatal finding of a congenital heart disease and a suggested diagnostic process.
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Affiliation(s)
- Florencia Petracchi
- Sección Genética Departamento de Ginecología y Obstetricia, CEMIC Instituto Universitario, Buenos Aires, Argentina
| | - Silvina Sisterna
- Sección Genética Departamento de Ginecología y Obstetricia, CEMIC Instituto Universitario, Buenos Aires, Argentina
| | - Laura Igarzabal
- Sección Genética Departamento de Ginecología y Obstetricia, CEMIC Instituto Universitario, Buenos Aires, Argentina
| | - Louise Wilkins-Haug
- Harvard Medical School Department of Obstetrics, Gynecology and Reproductive Medicine Division Chief Maternal Fetal Medicine and Reproductive Genetics, Brigham and Women's Hospital, Boston, MA
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5
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Sotiriadis A, Diamanti E, Chatzinikolaou F. Goldenhar syndrome presenting atypically with an additional cranial bone. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:352-353. [PMID: 25042723 DOI: 10.1002/uog.14635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 07/07/2014] [Indexed: 06/03/2023]
Affiliation(s)
- A Sotiriadis
- Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokrateio General Hospital, Thessaloniki, Greece
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Valdez CM, Altmayer SP, Barrow MA, Telles JA, Betat RDS, Zen PR, Rosa RF. Encephalocele-radial, cardiac, gastrointestinal, anal/renal anomalies: Novel evidence for a new condition? Am J Med Genet A 2014; 164A:1085-91. [DOI: 10.1002/ajmg.a.36426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 11/25/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Carolina M. Valdez
- Department of Ginecology and Obstetrics; Hospital Materno Infantil Presidente Vargas (HMIPV); Porto Alegre RS Brazil
| | - Stephan P.L. Altmayer
- Department of Medicine; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA); Porto Alegre RS Brazil
| | - McArthur A. Barrow
- Department of Medicine; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA); Porto Alegre RS Brazil
| | | | | | - Paulo R.G. Zen
- Department of Pathology; UFCSPA; Porto Alegre RS Brazil
- Department of Clinical Genetics; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA); Porto Alegre RS Brazil
| | - Rafael F.M. Rosa
- Department of Fetal Medicine; HMIPV; Porto Alegre RS Brazil
- Department of Pathology; UFCSPA; Porto Alegre RS Brazil
- Department of Clinical Genetics; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA); Porto Alegre RS Brazil
- Department of Clinical Genetics; HMIPV; Porto Alegre RS Brazil
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7
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Magge KT, Kim J, Rogers GF, Oh AK. Atypical expanded-spectrum hemifacial microsomia: a case report. Cleft Palate Craniofac J 2014; 52:240-5. [PMID: 24605928 DOI: 10.1597/13-210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective : To present the case report of a patient with expanded hemifacial microsomia (HFM) that illustrates the complex interactions of these embryogenic factors and to review current theories and mechanism regarding the etiopathogenesis of HFM. Design and Method : We present the case of an African American girl who was born at full term by cesarean section and transferred to our institution for systemic malformations. Her craniofacial findings include holoprosencephaly, cleft lip and palate, low set and posteriorly rotated ears, flat midfacial features, micrognathia, left HFM with grade 1 microtia, hypoplastic mandible, and a small preauricular pharyngeal arch remnant. Systemic anomalies included ectopic kidney, atrial-septal defect, bilateral hip dysplasia, bilateral humeroradial fusion, bilateral club feet, and bilateral low-set thumbs with the right side also being triphalangeal. Genetic evaluation did not identify a molecular diagnosis or other known syndrome. Conclusions : Although vasculogenic disruption of the stapedial artery during early fetal gestation has been implicated in the etiology of HFM, the grouping and bilateral findings seen in our patient argue against this relatively simple and localized phenomenon. Instead, such diverse and widespread anomalies in the setting of expanded spectrum HFM seem to support the theory of a disorder in blastogenesis as the cause of HFM.
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Barisic I, Odak L, Loane M, Garne E, Wellesley D, Calzolari E, Dolk H, Addor MC, Arriola L, Bergman J, Bianca S, Doray B, Khoshnood B, Klungsoyr K, McDonnell B, Pierini A, Rankin J, Rissmann A, Rounding C, Queisser-Luft A, Scarano G, Tucker D. Prevalence, prenatal diagnosis and clinical features of oculo-auriculo-vertebral spectrum: a registry-based study in Europe. Eur J Hum Genet 2014; 22:1026-33. [PMID: 24398798 DOI: 10.1038/ejhg.2013.287] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 11/02/2013] [Accepted: 11/09/2013] [Indexed: 11/09/2022] Open
Abstract
Oculo-auriculo-vertebral spectrum is a complex developmental disorder characterised mainly by anomalies of the ear, hemifacial microsomia, epibulbar dermoids and vertebral anomalies. The aetiology is largely unknown, and the epidemiological data are limited and inconsistent. We present the largest population-based epidemiological study to date, using data provided by the large network of congenital anomalies registries in Europe. The study population included infants diagnosed with oculo-auriculo-vertebral spectrum during the 1990-2009 period from 34 registries active in 16 European countries. Of the 355 infants diagnosed with oculo-auriculo-vertebral spectrum, there were 95.8% (340/355) live born, 0.8% (3/355) fetal deaths, 3.4% (12/355) terminations of pregnancy for fetal anomaly and 1.5% (5/340) neonatal deaths. In 18.9%, there was prenatal detection of anomaly/anomalies associated with oculo-auriculo-vertebral spectrum, 69.7% were diagnosed at birth, 3.9% in the first week of life and 6.1% within 1 year of life. Microtia (88.8%), hemifacial microsomia (49.0%) and ear tags (44.4%) were the most frequent anomalies, followed by atresia/stenosis of external auditory canal (25.1%), diverse vertebral (24.3%) and eye (24.3%) anomalies. There was a high rate (69.5%) of associated anomalies of other organs/systems. The most common were congenital heart defects present in 27.8% of patients. The prevalence of oculo-auriculo-vertebral spectrum, defined as microtia/ear anomalies and at least one major characteristic anomaly, was 3.8 per 100,000 births. Twinning, assisted reproductive techniques and maternal pre-pregnancy diabetes were confirmed as risk factors. The high rate of different associated anomalies points to the need of performing an early ultrasound screening in all infants born with this disorder.
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Affiliation(s)
- Ingeborg Barisic
- Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Ljubica Odak
- Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Maria Loane
- EUROCAT Central Registry, Room 12L09, University of Ulster, Ulster, Northern Ireland, UK
| | - Ester Garne
- Pediatric Department, Hospital Lillebaelt, Kolding, Denmark
| | - Diana Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Elisa Calzolari
- Registro IMER, Azienda Ospedaliero-Unifersitaria di Ferrara, Ferrara, Italy
| | - Helen Dolk
- EUROCAT Central Registry, Room 12L09, University of Ulster, Ulster, Northern Ireland, UK
| | | | - Larraitz Arriola
- Registro Anomalias Congenitas CAV, Direccion de Salud Publica, Donostia San Sebastian, Spain
| | - Jorieke Bergman
- Eurocat Registration Northern Netherlands, Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Berenice Doray
- Service de genetique Medicale, Hopitale de Hautepierre, Strasbourg Cedex, France
| | - Babak Khoshnood
- Paris Registry of Congenital Malformations, INSERM U953, Maternite de Port-Royal, Paris, France
| | - Kari Klungsoyr
- Medical Birth Registry of Norway, Norwegian Institute of Public Health, and Department of Public Global Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Bob McDonnell
- Health Information Unit, Health Service Executive, Dr Steevens Hospital, Dublin, Ireland
| | - Anna Pierini
- CNR Institute of Clinical Physiology, Pisa, Italy
| | - Judith Rankin
- Institute of Health and Society Newcastle University, Newcastle upon Tyne, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | | | | | - Gioacchino Scarano
- Registro Campano Difetti Congeniti, Azienda Ospedaliera "G Rummo", Benevento, Italy
| | - David Tucker
- Congenital Anomaly Register and Info Service Public Health Level 3 West Wing, Singleton Hospital, Wales, UK
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Ballesta-Martínez MJ, López-González V, Dulcet LA, Rodríguez-Santiago B, Garcia-Miñaúr S, Guillen-Navarro E. Autosomal dominant oculoauriculovertebral spectrum and 14q23.1 microduplication. Am J Med Genet A 2013; 161A:2030-5. [DOI: 10.1002/ajmg.a.36007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/01/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Maria Juliana Ballesta-Martínez
- Unidad de Genética Médica y Dismorfología, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca; Murcia; Spain
| | - Vanesa López-González
- Unidad de Genética Médica y Dismorfología, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca; Murcia; Spain
| | | | | | - Sixto Garcia-Miñaúr
- Instituto de Genética Médica y Molecular-INGEMM, Hospital Universitario La Paz; Madrid; Spain
| | - Encarna Guillen-Navarro
- Unidad de Genética Médica y Dismorfología, Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca; Murcia; Spain
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10
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Usefulness of magnetic resonance imaging in the prenatal study of malformations of the face and neck. RADIOLOGIA 2012. [DOI: 10.1016/j.rxeng.2011.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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11
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Zugazaga Cortazar A, Martín Martínez C. Utilidad de la resonancia magnética en el estudio prenatal de las malformaciones de la cara y el cuello. RADIOLOGIA 2012; 54:387-400. [DOI: 10.1016/j.rx.2011.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/17/2011] [Accepted: 05/19/2011] [Indexed: 10/28/2022]
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12
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Gawrych E, Janiszewska-Olszowska J, Chojnacka H. Oculoauriculovertebral spectrum with a full range of severe clinical manifestations--case report. J Craniomaxillofac Surg 2011; 42:2064-8. [PMID: 22154733 DOI: 10.1016/j.jcms.2011.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 10/04/2011] [Accepted: 10/07/2011] [Indexed: 10/14/2022] Open
Abstract
Oculoauriculovertebral spectrum (OAVS) is a rare congenital malformation consisting of epibulbar dermoids, lid colobomas, auricular deformities, hypoplasia of the soft and bony tissues of the face, associated oral deformities and vertebral anomalies. This report presents a child with a choroid of the right eye, coloboma of the upper eyelid, epibulbar dermoid of the left eye, mandibular hypoplasia, facial asymmetry, bilateral complete cleft lip and palate, hypoplasia of the left alar cartilage, appendage of the left nose, butterfly vertebral defects of Th-1, Th-2 and abnormality of rib XI. Widened sulci of frontal and parietal lobes, bilateral white matter density decrease and calcifications of falx cerebelli were noted. Axial hypotony and delayed psycho-motor development were apparent. This rare case presents a range of severe clinical manifestations of oculoauriculovertebral spectrum. Despite a normal cervical vertebral column, tracheostenosis was present. It caused difficulties in tracheal intubation, creating the need for a tracheostomy, and death after a failed attempt at decannulation. This case indicates that in patients with clinical manifestations including cerebral anomalies, a risk of respiratory insufficiency should be always taken under consideration, when planning surgery.
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Affiliation(s)
- Elżbieta Gawrych
- Department of Paediatric and Oncological Surgery (Head of Department: Elzbieta Gawrych, MD, PhD), Pomeranian Medical University, Szczecin, Poland.
| | - Joanna Janiszewska-Olszowska
- Department of Orthodontics (Head of Department: Krzysztof Wozniak, MD, PhD), Pomeranian Medical University, Szczecin, Poland
| | - Hanna Chojnacka
- Department of Paediatric and Oncological Surgery (Head of Department: Elzbieta Gawrych, MD, PhD), Pomeranian Medical University, Szczecin, Poland
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13
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Haratz K, Vinkler C, Lev D, Schreiber L, Malinger G. Hemifacial microsomia with spinal and rib anomalies: prenatal diagnosis and postmortem confirmation using 3-D computed tomography reconstruction. Fetal Diagn Ther 2011; 30:309-13. [PMID: 21997517 DOI: 10.1159/000330121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 05/23/2011] [Indexed: 11/19/2022]
Abstract
Hemifacial microsomia (OMIM164210) is a condition featuring unilateral ear anomalies and ocular epibulbar dermoids associated with unilateral underdevelopment of the craniofacial bony structures. Other associated anomalies have also been described, especially spinal malformations, and the term oculoauriculovertebral dysplasia spectrum (OVAS) was suggested to include the three predominant systems involved. Both genetic and environmental causes are implied in the pathogenesis of the syndrome, with a 3% recurrence rate according to reports of both vertical transmission and affected siblings. No specific gene was identified, albeit mutations in chromosome 10 and deficiencies of genes in the endothelin pathway in mice exhibited the same clinical features. We hereby describe the first case of prenatal diagnosis of spinal and rib malformations associated to hemifacial microsomia by means of 2-D and 3-D ultrasound in a 23-week fetus. The sonographic study depicted fetal scoliosis due to the presence of hemivertebrae, Sprengel's deformity of the left shoulder, ribs fusion, asymmetric ears with unilateral microtia, mandible unilateral hypoplasia as well as single umbilical artery and a 'golf ball' sign in the left ventricle of the heart. The diagnosis of OVAS was suggested and the family received proper genetic consultation. After termination of the pregnancy, the syndrome was confirmed by postmortem 3-D computed tomography study. In view of the grim outcome, prenatal death rate and high mortality and morbidity when three or more systems are involved, prenatal diagnosis and appropriate counseling are warranted.
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Affiliation(s)
- Karina Haratz
- Fetal Neurology Clinic, Edith Wolfson Medical Center, Holon, Israel
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14
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Heude E, Rivals I, Couly G, Levi G. Masticatory muscle defects in hemifacial microsomia: a new embryological concept. Am J Med Genet A 2011; 155A:1991-5. [PMID: 21744489 DOI: 10.1002/ajmg.a.34095] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 04/13/2011] [Indexed: 12/14/2022]
Abstract
First arch syndromes correspond to a wide spectrum of human latero-facial congenital anomalies affecting cranial neural crest cells (CNCCs) derivatives of the first pharyngeal arch (PA1). The abnormal traits display variable quantitative expression and are often unilateral. Mandibular skeletal defects are invariably accompanied by hypoplasia or agenesis of masticatory muscles, but no explanation has been proposed for this association. Indeed, during embryonic development, CNCCs give only rise to skeletal components of the head while muscles derive from cephalic myogenic mesodermal cells (CMMCs). Recent studies on animal models have shown that communication between CNCCs and CMMCs is essential for the development of masticatory muscles: genetic lesions affecting only CNCCs can prevent muscularization of the jaws. To evaluate the involvement of CNCC/CMMC interactions in human craniofacial development, we performed a quantitative analysis of masticatory muscle and mandibular bone volumes on craniofacial CT-scans from 8 children, ages 3 months to 16 years, affected by hemifacial microsomia. We found that: (1) in seven patients the masseter muscle is absent in the affected side; (2) the absence of masseter is correlated neither with the age of the patients nor with the volume and shape of the affected ramus; and (3) in all cases the pterygoid and the temporal muscles are either reduced or absent. Our findings suggest that an early developmental event is the origin of the muscular defects in these patients. We propose that the hypoplasia or agenesis of masticatory muscles derives from a defect in the CNCCs/CMMCs communication during early embryonic development.
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Affiliation(s)
- Eglantine Heude
- Évolution des Régulations Endocriniennes, UMR CNRS 7221, Muséum National d'Histoire Naturelle, Paris, France
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15
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Prenatal evaluation of the middle ear and diagnosis of middle ear hypoplasia using MRI. Pediatr Radiol 2011; 41:652-7. [PMID: 21140143 DOI: 10.1007/s00247-010-1913-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 09/13/2010] [Accepted: 10/16/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Analysis of the middle ear with fetal MRI has not been previously reported. OBJECTIVE To show the contribution of fetal MRI to middle ear imaging. MATERIALS AND METHODS The tympanic cavity was evaluated in 108 fetal cerebral MRI examinations (facial and/or cerebral malformation excluded) and in two cases, one of Treacher Collins syndrome (case 1) and the other of oculo-auriculo-vertebral (OUV) spectrum (case 2) with middle ear hypoplasia identified by MRI at 27 and 36 weeks' gestation, respectively. RESULTS In all 108 fetuses (mean gestational age 32.5 weeks), the tympanic cavity and T2 hypointensity related to the ossicles were well visualised on both sides. Case 1 had micro/retrognathia and bilateral external ear deformity and case 2 had retrognathism with a left low-set and deformed ear. MRI made it possible to recognize the marked hypoplasia of the tympanic cavity, which was bilateral in case 1 and unilateral in case 2. Both syndromes are characterized by craniofacial abnormalities including middle ear hypoplasia, which cannot be diagnosed with US. CONCLUSION The middle ear cavity can be visualized with fetal MRI. We emphasize the use of this imaging modality in the diagnosis of middle ear hypoplasia.
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Rosa RFM, Graziadio C, Lenhardt R, Alves RPM, Paskulin GA, Zen PRG. Central nervous system abnormalities in patients with oculo-auriculo-vertebral spectrum (Goldenhar syndrome). ARQUIVOS DE NEURO-PSIQUIATRIA 2010; 68:98-102. [PMID: 20339662 DOI: 10.1590/s0004-282x2010000100021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 10/26/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To describe the central nervous system (CNS) alterations present in a sample of oculo-auriculo-vertebral spectrum (OAVS) patients, trying to correlate them with other clinical features. METHOD Seventeen patients with diagnosis of OAVS were evaluated. All presented radiological evaluation of the CNS, normal GTG-Banding karyotype and clinical features involving at least two from the four following areas: oro-cranio-facial, ocular, auricular and vertebral. RESULTS CNS alterations were verified in eight from seventeen patients (47%). Diffuse cerebral hypoplasia, dilated lateral cerebral ventricles (asymptomatic hydrocephalus), corpus callosum dysgenesis and frontal hypodensities were the most frequent abnormalities. Presence of ophthalmologic abnormalities was the only clinical association observed, being significantly more frequent among patients with cerebral alterations (63% versus 11%). CONCLUSION CNS abnormalities are frequent in patients with OAVS, especially in carriers of ophthalmologic alterations. However, the absence of detectable cerebral abnormalities did not exclude the possibility that these subjects will subsequently present neurological symptoms.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- Santa Casa Hospital Complex of Porto Alegre, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
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Rosa RFM, Pfeil JN, Zen PRG, Rosa RCM, Graziadio C, Paskulin GA. Variabilidade fenotípica na síndrome do cromossomo supernumerário der(22)t(11;22) (síndrome de Emanuel). REVISTA PAULISTA DE PEDIATRIA 2010. [DOI: 10.1590/s0103-05822010000300017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Relatar dois pacientes com a síndrome de Emanuel (SE) ou cromossomo supernumerário der(22)t(11;22), secundária a translocações balanceadas familiares, apresentando fenótipos distintos. DESCRIÇÃO DE CASO: O primeiro paciente é uma menina branca de cinco anos de idade, apresentando hipotonia, atraso no desenvolvimento neuropsicomotor, movimentos estereotipados, microcefalia, ptose palpebral, orelhas proeminentes, fossetas e apêndices pré-auriculares, e imperfuração anal. As avaliações adicionais identificaram hipoplasia cerebral e estenose da válvula pulmonar. Possuía história também de laringotraqueomalácia e fenda palatina. O segundo paciente é um menino branco de seis meses de idade com hipotonia, movimentos coreoatetóticos, déficit de crescimento, microcefalia, microssomia hemifacial, fenda palatina, microtia, apêndices pré-auriculares e polegares proximalmente implantados. A ecocardiografia demonstrou estenose da válvula pulmonar, comunicação interatrial e interventricular, persistência do canal arterial e da veia cava superior esquerda. A radiografia de tórax identificou uma costela cervical. O cariótipo por bandas GTG mostrou a presença, em ambos os pacientes, de um cromossomo adicional der(22)t(11;22), secundário a uma translocação balanceada materna no primeiro caso e paterna no segundo caso. COMENTÁRIOS: Apesar de a primeira paciente apresentar achados frequentes da SE, o caso adicional representa a segunda descrição da literatura com um fenótipo de espectro óculo-aurículo-vertebral (EOAV). Assim, ambos salientam a variabilidade clínica observada na SE e a importância da avaliação cariotípica em indivíduos com fenótipo de EOAV.
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Brémond-Gignac D, Copin H, Elmaleh M, Milazzo S. Anomalies oculaires fœtales : apport de l’imagerie anténatale en résonance magnétique. J Fr Ophtalmol 2010; 33:350-4. [DOI: 10.1016/j.jfo.2010.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 03/03/2010] [Indexed: 11/29/2022]
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Mikhak Z, Mulliken JB, Lee J, Bonilla FA, Kimonis VE. Humoral immune deficiency and hemifacial microsomia seen in one family. Cleft Palate Craniofac J 2009; 46:477-80. [PMID: 19929099 DOI: 10.1597/08-169.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We present a patient with hemifacial microsomia and immune deficiency. The patient is a 5-year-old with grade III microtia and Pruzansky type I right mandibular hypoplasia. She developed 25 pulmonary infections in 3 years, required hospitalization every 6 weeks to receive antibiotics, and experienced recurrent herpes stomatitis and esophagitis, staphylococcal bacteremia, urinary tract, sinus, and ear infections. She had low total IgG, IgG1, IgG2, IgA, and anti-pneumococcal antibody levels. She was unable to maintain protective pneumococcal titers following vaccination. The patient's 7-year-old sister also suffered from recurrent infections, had a left facial skin tag, and a left arachnoid cyst. We conclude that immune deficiency can occur in association with hemifacial microsomia.
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Affiliation(s)
- Zamaneh Mikhak
- Harvard Medical School, Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, 02129, USA.
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Chen CP. Syndromes, disorders and maternal risk factors associated with neural tube defects (V). Taiwan J Obstet Gynecol 2009; 47:259-66. [PMID: 18935987 DOI: 10.1016/s1028-4559(08)60122-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Fetuses with neural tube defects (NTDs) may suffer from associated syndromes and disorders. This article provides a comprehensive review of the syndromes and disorders associated with NTDs, including Pallister-Hall syndrome, Walker-Warburg syndrome and Fukuyama congenital muscular dystrophy, MURCS association, Roberts syndrome, cerebro-costo-mandibular syndrome, laterality sequences, hydrolethalus syndrome, Knobloch syndrome, oculoauriculovertebral spectrum (hemifacial microsomia), cervico-oculo-acoustic syndrome, Fanconi anemia, Miller-Dieker lissencephaly syndrome, Fraser syndrome, frontonasal dysplasia, Adams-Oliver syndrome, CHILD syndrome, dyssegmental dysplasia, and monozygotic twinning. NTDs associated with these syndromes and disorders are a rare but important cause of NTDs. The risk of NTDs in subsequent fetuses and the preventive effect of maternal folic acid intake in NTDs associated with syndromes and disorders may be different from those of nonsyndromic multifactorial NTDs. Perinatal diagnosis of NTDs should alert doctors to the syndromes and disorders associated with NTDs, and prompt thorough etiologic investigation and genetic counseling.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
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Ou Z, Martin DM, Bedoyan JK, Cooper ML, Chinault AC, Stankiewicz P, Cheung SW. Branchiootorenal syndrome and oculoauriculovertebral spectrum features associated with duplication ofSIX1,SIX6, andOTX2resulting from a complex chromosomal rearrangement. Am J Med Genet A 2008; 146A:2480-9. [DOI: 10.1002/ajmg.a.32398] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Deshpande C, Hennekam RCM. Genetic syndromes and prenatally detected renal anomalies. Semin Fetal Neonatal Med 2008; 13:171-80. [PMID: 18162447 DOI: 10.1016/j.siny.2007.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Renal anomalies are frequently detected on the routine second trimester scan offered to all pregnant women in the UK. These anomalies may be isolated but can also be associated with other congenital anomalies. Many combinations of ultrasound scan findings constitute recognised genetic entities. Knowledge of these conditions is essential for adequate management of the pregnancy and subsequent balanced parental counselling. This short review discusses the common genetic syndromes associated with the renal abnormalities identified on the antenatal ultrasound scan, and also provides an overview of renal symptoms in chromosome imbalances and after teratogenic influences.
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Affiliation(s)
- C Deshpande
- Department of Clinical Genetics, Guy's Hospital, London, UK.
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Alasti F, Sadeghi A, Sanati MH, Farhadi M, Stollar E, Somers T, Van Camp G. A mutation in HOXA2 is responsible for autosomal-recessive microtia in an Iranian family. Am J Hum Genet 2008; 82:982-91. [PMID: 18394579 DOI: 10.1016/j.ajhg.2008.02.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 02/12/2008] [Accepted: 02/28/2008] [Indexed: 11/25/2022] Open
Abstract
Microtia, a congenital deformity manifesting as an abnormally shaped or absent external ear, occurs in one out of 8,000-10,000 births. We ascertained a consanguineous Iranian family segregating with autosomal-recessive bilateral microtia, mixed symmetrical severe to profound hearing impairment, and partial cleft palate. Genome-wide linkage analysis localized the responsible gene to chromosome 7p14.3-p15.3 with a maximum multi-point LOD score of 4.17. In this region, homeobox genes from the HOXA cluster were the most interesting candidates. Subsequent DNA sequence analysis of the HOXA1 and HOXA2 homeobox genes from the candidate region identified an interesting HOXA2 homeodomain variant: a change in a highly conserved amino acid (p.Q186K). The variant was not found in 231 Iranian and 109 Belgian control samples. The critical contribution of HoxA2 for auditory-system development has already been shown in mouse models. We built a homology model to predict the effect of this mutation on the structure and DNA-binding activity of the homeodomain by using the program Modeler 8v2. In the model of the mutant homeodomain, the position of the mutant lysine side chain is consistently farther away from a nearby phosphate group; this altered position results in the loss of a hydrogen bond and affects the DNA-binding activity.
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Vendramini S, Richieri-Costa A, Guion-Almeida ML. Oculoauriculovertebral spectrum with radial defects: a new syndrome or an extension of the oculoauriculovertebral spectrum? Report of fourteen Brazilian cases and review of the literature. Eur J Hum Genet 2007; 15:411-21. [PMID: 17290277 DOI: 10.1038/sj.ejhg.5201770] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The first and second branchial arches are embryonic primordium that contributes to craniofacial development. Interferences in normal development of these structures result in variable maxillary, mandibular, and ear abnormalities. These anomalies can be isolated or part of some known and unknown conditions, among them, the oculoauriculovertebral spectrum (OAVS). Malformations of the external ear or microtia are mandatory features of the OAVS and occur as an isolated malformation (population frequency of 0.03%), or in association with other anomalies such as mandible hypoplasia, epibulbar dermoids, and spinal vertebral defects. Extreme variability of phenotypic manifestations is the main feature of the OAVS and, developmental anomalies are not restricted to facial structures. Cardiac, pulmonary, renal, skeletal, and central nervous system involvements have been observed in patients presented with this condition. Radial defects, although rare, have been reported. In this study, we report on the clinical aspects of 14 Brazilian patients with first and second branchial arches abnormalities associated with radial defects and we compared these data with those of 26 cases in the literature. We postulate that radial defects associated with OAVS might represent a subset within this spectrum.
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Affiliation(s)
- Siulan Vendramini
- Department of Clinical Genetics, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, Brazil.
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