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Arif H, Ashraf R, Khan F, Khattak YR, Nisar H, Ahmad I. Total temporomandibular joint reconstruction prosthesis in hemifacial microsomia: A systematic review. Orthod Craniofac Res 2024; 27:15-26. [PMID: 37533308 DOI: 10.1111/ocr.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
Hypoplastic asymmetry due to hemifacial microsomia (HFM) often represents the most difficult reconstruction in the craniomaxillofacial clinic. Although autogenous grafts are generally used for temporomandibular joint reconstruction (TMJR), the use of TMJR prostheses is not well established. The aim of this review was to identify, collect and analyse the use of extended TMJR (eTMJR) prostheses in patients with HFM, describing clinical features, surgical procedures and postoperative complications. Online searches of all major databases were performed according to PRISMA guidelines. All studies with HFM patients treated with the eTMJR prostheses were included. Descriptive statistics were used for data analysis. A total of 19 studies, including 08 case studies, 06 case series and 05 retrospective cohort studies, met the inclusion criteria, where a total of 42 HFM patients were reported from 18 countries, mostly from the United States (05; 26%). Fifteen of the 42 cases (~36%) were male. The mean ± SD (range) age of patients in all studies was 19.79 ± 5.81 (9-36) years. The mean ± SD (range) of patient follow-up was 41.30 ± 35.50 (6-136) months. A total of 5 (10.6%) patients were implanted with bilateral eTMJR prostheses. The Pruzansky classification was used in 18 (~89.5%) studies, OMENS classification in 01 (~5%) study, whereas no classification was reported in one study. Only 01 (7.1%) study had documented the eTMJR classification for the prosthesis used. In growing patients with or without a history of failed autogenous tissues, TMJR prostheses may provide a viable alternative. Randomized studies with large cohorts are warranted to validate these preliminary results.
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Affiliation(s)
- H Arif
- Nishtar Hospital, Multan, Pakistan
| | - R Ashraf
- Nishtar Hospital, Multan, Pakistan
| | - F Khan
- Services Institute of Medical Sciences, Lahore, Pakistan
| | - Y R Khattak
- Oral and Maxillofacial Surgery, Hayatabad Medical Complex, Peshawar, Pakistan
| | - H Nisar
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - I Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
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Kinter S, Kotlarek K, Meehan A, Heike C. Characterizing Speech Phenotype in Individuals With Craniofacial Microsomia: A Scoping Review. Am J Speech Lang Pathol 2024; 33:485-504. [PMID: 37931079 PMCID: PMC11001184 DOI: 10.1044/2023_ajslp-23-00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/28/2023] [Accepted: 08/25/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Craniofacial microsomia (CFM) is a complex congenital condition primarily affecting the ear, mandible, facial nerve and muscles, and tongue. Individuals with CFM are at increased risk of hearing loss, obstructive sleep apnea, and feeding/swallowing difficulties. The purpose of this scoping review was to summarize evidence pertaining to speech production in CFM. METHOD All articles reporting any characteristic of speech production in CFM were included and screened by two independent reviewers by title, abstract, and full text. Data charting captured details related to study population and design, CFM diagnostic criteria, speech outcome measurement, and key findings. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist guided reporting of results. Our protocol was registered on the Open Science Framework (https://osf.io/npr94/) and published elsewhere. RESULTS Forty-five articles were included in the detailed review. Most articles originated from the United States, were published in the past decade, and utilized case report/series study design. A speech-language pathologist authored 29%. The prevalence of velopharyngeal insufficiency ranged from 19% to 55% among studies. Oral distortion of alveolar and palatal fricatives and affricates primarily characterized articulation errors. Studies identified increased disordered speech and lower intelligibility in adolescents with CFM compared to unaffected peers. Evidence pertaining to phonatory and respiratory speech findings is limited. CONCLUSIONS Evidence supports that individuals with CFM are at increased risk of both velopharyngeal and articulatory speech differences. Additional information is needed to develop speech screening guidelines for children with CFM. Heterogeneity in study design and outcome measurement precludes comparisons across studies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24424555.
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Affiliation(s)
- Sara Kinter
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle
- Craniofacial Center, Seattle Children's Hospital, WA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, WA
| | - Katelyn Kotlarek
- Division of Communication Disorders, College of Health Sciences, University of Wyoming, Laramie
| | - Anna Meehan
- Craniofacial Center, Seattle Children's Hospital, WA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, WA
| | - Carrie Heike
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle
- Craniofacial Center, Seattle Children's Hospital, WA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, WA
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Park H, Ahn S. Vascular variation of temporoparietal fascia in microtia associated with hemifacial microsomia. J Craniomaxillofac Surg 2024; 52:40-47. [PMID: 38129190 DOI: 10.1016/j.jcms.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
The study analyzed vascular variations in microtia associated with hemifacial microsomia (HFM). A retrospective analysis was conducted on 47 patients with microtia and HFM, who underwent computed tomography angiography between November 2011 and May 2022. The vascular course and branching supplying the TPF were analyzed. Craniometric measurements were conducted to determine the horizontal distance from the porion and fronto-zygomatic suture (F-Z suture) to the vessels. On the affected side, the TPF was primarily supplied by either the superficial temporal artery (STA) or the postauricular artery-originated STA (Po-STA). The Po-STA (n = 29) was more prevalent than the STA (n = 18), and mostly exhibited a single frontal branch (n = 20). Craniometric analysis revealed that the Po-STA was closer to the porion, ear vestige, and F-Z suture than the STA on the non-affected side. Furthermore, a significant correlation was observed between the severity of mandibular hypoplasia and presence of Po-STA variation (Cramer's V = 0.498, p = 0.005). Microtia associated with HFM exhibits vascular variations in the TPF - in particular, a unique Po-STA variation. The Po-STA is prone to injury during ear reconstruction because of its proximity to the external auditory canal and ear vestige. Surgeons should be cautious of these anatomical variations for safer ear reconstruction procedures, and utilize preoperative imaging for meticulous planning.
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Affiliation(s)
- Hojin Park
- Department of Plastic Surgery, Korea University, College of Medicine, Korea University Anam Hospital, Seoul, South Korea.
| | - Sihyun Ahn
- Department of Plastic Surgery, Korea University, College of Medicine, Korea University Anam Hospital, Seoul, South Korea
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Shahraki K, Hakimeh C, Suh DW. Modified horizontal muscle transposition without tenotomy and splitting for a case of inferior rectus and inferior oblique muscles aplasia with hemifacial microsomia. J AAPOS 2023; 27:354-357. [PMID: 37741493 DOI: 10.1016/j.jaapos.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 09/25/2023]
Abstract
Aplasia of the inferior rectus and inferior oblique muscles is extremely rare. Failure of the normal embryologic development of the inferior mesodermal complex can lead to agenesis of inferior rectus, inferior oblique, and lower sections of the lateral rectus muscles. This rare condition is usually seen in association with craniofacial syndromes or in conjunction with microcornea, microphthalmos, Axenfeld-Rieger syndrome, and coloboma. The usual treatment for this condition is a reverse Knapp procedure to improve the vertical alignment; however, this procedure can lead to complications, such as anterior segment ischemia, undercorrection, and torsional problems. To our knowledge, unilateral inferior rectus and inferior oblique muscle aplasia has not been described previously in a patient with congenital facial nerve palsy and optic nerve hypoplasia. In the present case, the patient was successfully treated with a modified minimally invasive horizontal rectus muscle transposition procedure.
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Affiliation(s)
- Kourosh Shahraki
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine
| | - Christine Hakimeh
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine
| | - Donny W Suh
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine.
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Luo S, Sun H, Bian Q, Liu Z, Wang X. The etiology, clinical features, and treatment options of hemifacial microsomia. Oral Dis 2023; 29:2449-2462. [PMID: 36648381 DOI: 10.1111/odi.14508] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
The second most frequent craniomaxillofacial congenital deformity is hemifacial microsomia (HFM). Patients often accompany short mandible, ear dysplasia, facial nerve, and soft tissue dysplasia. The etiology of HFM is not fully understood. To organize the possible up-to-date information on the etiology, craniofacial phenotypes, and therapeutic alternatives in order to fully comprehend the HFM. Reviewing the potential causes, exploring the clinical features of HFM and summarizing the available treatment options. Vascular malformation, Meckel's cartilage abnormalities, and cranial neural crest cells (CNCCs) abnormalities are three potential etiology hypotheses. The commonly used clinical classification for HFM is OMENS, OMENS-plus, and SAT. Other craniofacial anomalies, like dental defects, and zygomatic deformities, are still not precisely documented in the classification. Patients with moderate phenotypes may not need any treatment from infancy through adulthood. However, patients with severe HFM require to undergo multiple surgeries to address facial asymmetries, such as mandibular distraction osteogenesis (MDO), autologous costochondral rib graft (CCG), orthodontic and orthognathic treatment, and facial soft tissue reconstruction. It is anticipated that etiology research will examine the pathogenic mechanism of HFM. A precise treatment for HFM may be possible with thoroughly documented phenotypes and a pathogenic diagnosis.
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Affiliation(s)
- Songyuan Luo
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hao Sun
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Qian Bian
- Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Precision Medicine, Shanghai, China
| | - Zhixu Liu
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xudong Wang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Ren M, Li R, Liu L. Goldenhar Syndrome Patient with Craniocerebral Lesion. Ophthalmology 2023; 130:913. [PMID: 37599590 DOI: 10.1016/j.ophtha.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mingyu Ren
- Department of Orbital Disease and Ocular Tumor, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Ruimiao Li
- Department of Orbital Disease and Ocular Tumor, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Limin Liu
- Department of Orbital Disease and Ocular Tumor, Hebei Eye Hospital, Xingtai, Hebei Province, China
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Wang XD, Zhu M. [Sequential treatment of oral and maxillofacial deformities with hemifacial microsomia]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:781-790. [PMID: 37550038 DOI: 10.3760/cma.j.cn112144-20230420-00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The incidence of the first and second branchial arch syndrome namely hemifacial microsomia (HFM) is the second only to cleft lip and palate, and it is a very common craniofacial developmental deformity. This congenital condition affects the development of the orbit, ear, and mandible, and the clinical manifestations of each patient are significantly heterogeneous. Clinical treatment needs to formulate corresponding treatment measures according to different degrees of tissue deformity at different ages. This article puts forward personal suggestions for the sequential treatment of oral and maxillofacial deformities of HFM from the perspective of patient age and classification.
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Affiliation(s)
- X D Wang
- Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - M Zhu
- Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Spierer O. Modified Nishida's procedure for esotropia in Duane syndrome associated with Goldenhar syndrome. J AAPOS 2023; 27:224-226. [PMID: 37247805 DOI: 10.1016/j.jaapos.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/31/2023]
Abstract
Modified Nishida's procedure (no split, no tenotomy transposition) has been recently described as an effective surgery for monocular elevation deficiency and for traumatic rupture of the inferior rectus muscle. We report the modified Nishida's procedure combined with medial rectus muscle recession for the treatment of esotropia in unilateral Duane syndrome associated with Goldenhar syndrome. Following the surgery and over a 1-year follow-up period, the patient was orthophoric at distance and near, abduction improved, and the abnormal head position resolved.
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Affiliation(s)
- Oriel Spierer
- Department of Ophthalmology, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Xing F, Deng XM, Yang D. Goldenhar syndrome complicated with subglottic airway stenosis: a case report. BMC Anesthesiol 2023; 23:210. [PMID: 37328815 PMCID: PMC10273538 DOI: 10.1186/s12871-023-02179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/14/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Goldenhar syndrome is a congenital disease that involves an absence or underdevelopment of structures that arise from the first and second pharyngeal arches and more or less severe extracranial anomalies. A variety of supraglottic malformations may be observed, including mandibular hypoplasia, mandibular asymmetry and micrognathia. Subglottic airway stenosis (SGS), which can cause difficulties in airway management during the perioperative period, is seldom emphasized in literature descriptions of Goldenhar syndrome, but can be clinically significant. CASE PRESENTATION An 18-year-old female with a history of Goldenhar syndrome presented for placement of a right mandibular distractor, right retroauricular dilator, and stage I transfer of a prefabricated expanded flap under general anesthesia. During tracheal intubation, the endotracheal tube (ETT) met resistance unexpectantly when attempting to pass through the glottis. Subsequently, we attempted the procedure with a smaller size ETT but again met resistance. With fiberoptic bronchoscope, we found that the whole segment of the trachea and bilateral bronchi were obvious narrow. Given the finding of unexpected severe airway stenosis and the associated risks with proceeding with the surgery, the operation was cancelled. We removed the ETT once the patient was fully awake. CONCLUSIONS Anesthesiologists should be aware of this clinical finding when evaluating the airway of a patient with Goldenhar syndrome. Coronal and sagittal measurements on computerized tomography (CT) and three-dimensional image reconstruction can be used to evaluate the degree of subglottic airway stenosis and measure the diameter of the trachea.
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Affiliation(s)
- Fei Xing
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, People's Republic of China
| | - Xiao Ming Deng
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, People's Republic of China
| | - Dong Yang
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, People's Republic of China.
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Gonçalves Ferraz B, Vendramini-Pittoli S, Gomes LP, Madeira Brandão M, Alonso N, Tonello C. Craniofacial Microsomia: New Updates in Spinal Anomalies. J Craniofac Surg 2023; 34:e398-e401. [PMID: 37126414 DOI: 10.1097/scs.0000000000009326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/19/2023] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION Craniofacial microsomia (CFM) involves anomalies of the first and second pharyngeal arches, mainly of the mandible, maxilla, ears, and vertebral spine. This study aimed to identify the frequency and morphology of spinal anomalies of individuals with clinical diagnoses of CFM. In addition, the correlation between spinal anomalies and craniofacial involvement was performed. MATERIALS AND METHODS This study was a retrospective review of individuals with a clinical diagnosis of craniofacial microsomia. The inclusion criteria were a clinical diagnosis of CFM with no overlap with any other syndromes of first and second pharyngeal arches and radiograph availability in the hospital's database. Prevalence and morphology of spinal anomalies were calculated and clinical details were recorded: types of spinal anomalies and correlations according to OMENS score. RESULTS The sample consisted of 46 individuals with a clinical diagnosis of CFM, 24 (52,2%) female and 22 (47,8%) male (1M:1F). Twenty-one (45,7%) had unilateral craniofacial involvement and 25 (54,3%), bilateral. Twenty-eight (60,9%) individuals presented spinal anomalies. Those with unaltered spinal morphology showed a slight preference toward OMENS scores under 5: 7 patients did, only one of which had spinal alterations (14,3%); 68,8% (22) in the group with scores 5 to 9 (n=32) and 71,4% (5) in the 10 to 15 group (n=7) did as well. DISCUSSION AND CONCLUSIONS Spinal anomalies in individuals with CFM are more common than usually reported in medical literature, mainly when associated with radial anomalies and correlate with statistical significance to facial features, mainly the OMENS score.
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Affiliation(s)
| | - Siulan Vendramini-Pittoli
- Division of Clinical Genetics, University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies
| | - Luiz Paulo Gomes
- University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies, Bauru
| | - Michele Madeira Brandão
- Division of Clinical Genetics, University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies
| | - Nivaldo Alonso
- University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies, Bauru
- University of São Paulo (USP), School of Medicine, São Paulo, São Paulo, Brazil
| | - Cristiano Tonello
- University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies, Bauru
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Bergonzini L, Pruccoli J, Parmeggiani A. Avoidant-restrictive food intake disorder in a male patient with Goldenhar syndrome. Eat Weight Disord 2022; 27:3803-3807. [PMID: 36310338 PMCID: PMC9618299 DOI: 10.1007/s40519-022-01497-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/16/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Goldenhar syndrome (GS) is a rare congenital condition characterized by the underdevelopment of structures deriving from the first and second branchial arches. Clinical phenotype might encompass extra-craniofacial abnormalities, and patients may experience neuropsychiatric disorders with a higher prevalence than healthy controls. To the best of our knowledge, an association between GS and Feeding and Eating Disorders (FED) has never been reported in the literature. CASE REPORT A 15-year-old boy with GS was referred to our outpatient clinic due to severe underweight (BMI of 12.7 kg/m2) and food intake disorder with avoidant restrictive features. After a diagnosis of avoidant-restrictive food intake disorder (ARFID) was made, an inpatient multidisciplinary intervention and outpatient follow-up program were provided, which resulted in the improvement of the boy's weight and FED psychopathology. CONCLUSIONS The current report describes the first case of a young male with GS and ARFID. We suggest that ARFID may present itself as part of the spectrum of neuropsychiatric disorders associated with the syndrome; since traumatic experiences and gastrointestinal discomfort play a pivotal role in the development of ARFID among children, attention should be paid to those affected by GS that involves crucial structures in the swallowing process. Further literature evidence will help portray the complex relationship between ARFID and GS more precisely. LEVEL OF EVIDENCE Level V, case report.
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Affiliation(s)
- Luca Bergonzini
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Centro Regionale Per I Disturbi Della Nutrizione E Dell'Alimentazione in Età Evolutiva, U.O. Neuropsichiatria Dell'età Pediatrica, Bologna, Italy
- Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), Università Di Bologna, Bologna, Italy
| | - Jacopo Pruccoli
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Centro Regionale Per I Disturbi Della Nutrizione E Dell'Alimentazione in Età Evolutiva, U.O. Neuropsichiatria Dell'età Pediatrica, Bologna, Italy
- Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), Università Di Bologna, Bologna, Italy
| | - Antonia Parmeggiani
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Centro Regionale Per I Disturbi Della Nutrizione E Dell'Alimentazione in Età Evolutiva, U.O. Neuropsichiatria Dell'età Pediatrica, Bologna, Italy.
- Dipartimento Di Scienze Mediche E Chirurgiche (DIMEC), Università Di Bologna, Bologna, Italy.
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Dong XQ, Zhang ZQ, Feng H, Cai L. [A case report of the first and second branchial arch syndrome with torticollis]. Zhonghua Yan Ke Za Zhi 2022; 58:923-924. [PMID: 36348531 DOI: 10.3760/cma.j.cn112142-20220421-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 54-month-old female patient presented to the department of ophthalmology with abnormal head posture and facial asymmetry for two years. The patient's facial development was asymmetrical, with the middle 1/3 of the left side shorter than the right side. The left ear is less malformed than the right. There was no obvious abnormality in corneal light reflex and eye movement. Head tilt test ( -). So, paralysis of the superior oblique muscle was excluded. In consultation with the department of maxillofacial surgery, the patient was confirmed as the first and second branchial arch syndrome and torticollis.
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Affiliation(s)
- X Q Dong
- Department of Ophthalmology, Shenzhen University General Hospital, Shenzhen 518000, China
| | - Z Q Zhang
- Department of Ophthalmology, Shenzhen University General Hospital, Shenzhen 518000, China
| | - H Feng
- Department of Ophthalmology, Shenzhen University General Hospital, Shenzhen 518000, China
| | - L Cai
- Department of Ophthalmology, Shenzhen University General Hospital, Shenzhen 518000, China
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Rathod D, Meshram T, Kumari K, Pal N. Airway challenges in an adult with hemifacial microsomia along with neglected cleft palate: what to expect? BMJ Case Rep 2022; 15:e247858. [PMID: 35338041 PMCID: PMC8961116 DOI: 10.1136/bcr-2021-247858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/03/2022] Open
Abstract
A female patient in her early 20s, with a known diagnosis of hemifacial microsomia (unilateral microtia and mandibular hypoplasia) accompanied with an unoperated cleft palate, came for an infected mandibular distraction plate removal. The anticipated difficult airway and lack of enough literature about what to expect in such a scenario, along with the psychological impact on the patient, made this case challenging and thought-provoking. Inability to perform the awake tracheal intubation because of the uncooperative patient, along with the difficult fibreoptic owing to narrowed nostrils, offered an extra set of challenges.
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Affiliation(s)
- Darshana Rathod
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences-Jodhpur, Jodhpur, Rajasthan, India
| | - Tanvi Meshram
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences-Jodhpur, Jodhpur, Rajasthan, India
| | - Kamlesh Kumari
- Anaesthesia, All India Institute of Medical Sciences-Jodhpur, Jodhpur, Rajasthan, India
| | - Nilay Pal
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences-Jodhpur, Jodhpur, Rajasthan, India
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Rollon-Mayordomo A, Mataix-Albert B, Espejo-Arjona F, Herce-Lopez J, Lledo-Villar L, Caparros-Escudero C, Infante-Cossio P. Neurotrophic Keratitis in a Pediatric Patient With Goldenhar Syndrome and Trigeminal Aplasia Successfully Treated by Corneal Neurotization. Ophthalmic Plast Reconstr Surg 2022; 38:e49-e51. [PMID: 34798657 DOI: 10.1097/iop.0000000000002086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Herein, the authors report an unusual case of a 6-year-old boy with right-sided Goldenhar syndrome and trigeminal nerve aplasia who developed neurotrophic keratopathy (NK). Despite the use of therapeutic contact lenses and multiple temporary tarsorrhaphy, NK worsened showing a central corneal scar, neovascularization, and significant stromal thinning, with risk of corneal perforation. Cochet-Bonnet esthesiometry revealed complete corneal anesthesia. To minimize additional corneal complications, the patient underwent indirect corneal neurotization by a sural nerve autograft anastomosed to the contralateral supratrochlear nerve. At 24-month follow up, no epithelial defects, complications, or recurrence were observed. Significant improvements in corneal sensitivity with esthesiometry score of 20 mm and reflex blinking were achieved. This case highlights corneal anesthesia should be suspected among Goldenhar syndrome ophthalmologic abnormalities and monitored before corneal changes become irreversible. Since corneal neurotization can successfully improve corneal sensation, it could be considered as an early therapeutic option to avoid refractory NK.
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Affiliation(s)
- Angel Rollon-Mayordomo
- Department of Oral and Maxillofacial Surgery, Virgen Macarena University Hospital, Seville, Spain
| | | | | | - Javier Herce-Lopez
- Department of Oral and Maxillofacial Surgery, Virgen Macarena University Hospital, Seville, Spain
| | - Leticia Lledo-Villar
- Department of Ophthalmology, Virgen Macarena University Hospital, Seville, Spain
| | | | - Pedro Infante-Cossio
- Department of Surgery, School of Medicine, University of Seville, Seville, Spain
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15
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Zizlavsky S, Anam K, Suwento R, Rahmawati I. The effects of Goldenhar Syndrome on hearing and speech development. Med J Malaysia 2021; 76:946-949. [PMID: 34806693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Goldenhar syndrome is a congenital abnormality with an incidence of 1 in 5,200 to 26,500 births. This syndrome is characterized by facial asymmetry, ear malformation, and/or defects in the eyes and vertebrae. The hearing disorder manifests as both conductive or sensorineural due to the abnormalities occurring in the inner and outer ear. We report a case of a 1-year-3-month-old child presenting with left anotia and right microtia, severe bilateral conductive hearing loss, and global delayed development. The patient was also found to have a hemifacial microsomia, a secundum atrial septal defect (ASD), and a ventricular septal defect (VSD). The patient was advised to use hearing aids and participate in speech therapy. The management of this Goldenhar syndrome patient should be done comprehensively, appropriate to the abnormalities found to achieve the best result.
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Affiliation(s)
- S Zizlavsky
- Cipto Mangunkusumo Hospital, Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head & Neck Surgery, Jakarta, Indonesia.
| | - K Anam
- Cipto Mangunkusumo Hospital, Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head & Neck Surgery, Jakarta, Indonesia
| | - R Suwento
- Cipto Mangunkusumo Hospital, Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head & Neck Surgery, Jakarta, Indonesia
| | - I Rahmawati
- Cipto Mangunkusumo Hospital, Universitas Indonesia, Faculty of Medicine, Department of Otorhinolaryngology-Head & Neck Surgery, Jakarta, Indonesia
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Yamada H, Sawada M, Tanaka E. Treatment of hemifacial microsomia using conventional orthodontic techniques: Report of a case with long-term follow-up. J Am Dent Assoc 2021; 152:653-668. [PMID: 33674034 DOI: 10.1016/j.adaj.2020.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/04/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OVERVIEW The authors successfully treat a case of hemifacial microsomia involving unilateral condylar hypoplasia using conventional orthodontic techniques followed by long-term retention. CASE DESCRIPTION A girl aged 10 years and 2 months received a diagnosis of hemifacial microsomia resulting from unilateral condylar hypoplasia. During a growth period, premature incisal contact was abolished. After her growth was complete, she received conventional orthodontic treatment with preadjusted edgewise appliances. After 27 months of multibracket treatment, acceptable occlusion with a class I canine and molar relationship was achieved. The occlusion remained stable throughout the 15-year retention period, although there was a slight facial change. CONCLUSIONS AND PRACTICAL IMPLICATIONS Early orthodontic management only can have some limitations but could be one of the treatment options for hemifacial microsomia.
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17
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Sharawat IK, Bhattacharya D, Saini L. Goldenhar Syndrome with Imperforate Anus: New Association or Coincidence! Indian J Pediatr 2019; 86:1150. [PMID: 31302873 DOI: 10.1007/s12098-019-03038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Deepanjan Bhattacharya
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Collett BR, Chapman K, Wallace ER, Kinter SL, Heike CL, Speltz ML, Werler M. Speech, Language, and Communication Skills of Adolescents With Craniofacial Microsomia. Am J Speech Lang Pathol 2019; 28:1571-1581. [PMID: 31580699 PMCID: PMC7251598 DOI: 10.1044/2019_ajslp-19-0089] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 06/10/2023]
Abstract
Purpose Youth with craniofacial microsomia (CFM) have anomalies and comorbidities that increase their risk for speech, language, and communication deficits. We examined these outcomes in youth with and without CFM and explored differences as a function of CFM phenotype and hearing status. Method Participants included youth ages 11-17 years with CFM (n = 107) and demographically similar controls (n = 306). We assessed speech intelligibility, articulation, receptive and expressive language, and parent and teacher report measures of communication. Hearing status was also screened at the study visit. Group differences were estimated using linear regression analyses with standardized effect sizes (ES) adjusted for demographic characteristics (adjusted ES) or negative binomial regression. Results Youth with CFM scored lower than unaffected peers on most measures of intelligibility, articulation, expressive language, and parent- and-teacher-rated communication. Differences were most pronounced among participants with CFM who had mandibular hypoplasia plus microtia (adjusted ES = -1.15 to -0.18). Group differences were larger in youth with CFM who failed the hearing screen (adjusted ES = -0.73 to 0.07) than in those who passed the hearing screen (adjusted ES = -0.34 to 0.27). Conclusions Youth with CFM, particularly those with mandibular hypoplasia plus microtia and/or hearing loss, should be closely monitored for speech and language concerns. Further research is needed to identify the specific needs of youth with CFM as well as to document the course of speech and language development in children with CFM.
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Affiliation(s)
- Brent R Collett
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, WA
| | - Kathy Chapman
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Erin R Wallace
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | | | | | - Matthew L Speltz
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, WA
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19
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Sims ME. Legal Briefs: Was the Adverse Outcome from Goldenhar Syndrome or Hypoxic-Ischemic Events? Neoreviews 2019; 20:e245-e247. [PMID: 31261068 DOI: 10.1542/neo.20-4-e245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Maureen E Sims
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA
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20
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Connell B, Oore JJ, Pahys JM, Thompson GH, St Hilaire T, Flynn T, El-Hawary R. Growth-Friendly Surgery Is Effective at Treating Early-Onset Scoliosis Associated With Goldenhar Syndrome. Spine Deform 2019; 6:327-333. [PMID: 29735145 DOI: 10.1016/j.jspd.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 11/12/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the radiographic results and complications of growth-friendly (GF) surgery in the treatment of early-onset scoliosis (EOS) associated with Goldenhar syndrome. BACKGROUND Goldenhar syndrome has been associated with spinal deformity, which may be progressive. Efficacy and complication rate of GF treatment has not been reported for this population of patients with EOS. METHODS Patients with Goldenhar syndrome and EOS with two years' follow-up were identified from two international multicenter EOS databases. Scoliosis, kyphosis, spine height, and hemithoracic height/width were determined preimplant, immediately postoperative, and at the two-year follow-up. Severity of complications (SV) was recorded (Smith et al. JPO 2015). RESULTS Ten patients met inclusion criteria and had a mean age of 4.6 ± 2.5 years at GF implantation (one spine and nine rib-based). Mean preoperative scoliosis was 64°, postimplant 52°, and at mean follow up of 2.4 ± 0.5 years was 50° (p = .09). Preoperative kyphosis was 36°, postimplant 38°, and final 42° (p = .08). Preoperative T1-S1 height was 23.5 cm, postimplant 23.6 cm, and final 27.3 cm (p = .06). Preoperative convex hemithoracic height was 10.4 cm, postimplant 7.9 cm, and final 12.8 cm (p < .05). Preoperative concave hemithoracic height was 8.4 cm, postimplant 8.8 cm, and final 9.9 cm (p = .30). Preoperative right hemithoracic width was 8.02 cm, postimplant 7.22 cm, and final 7.86 cm (p = .07). Preoperative left hemithoracic width was 7.18 cm, postimplant 7.86 cm, and final 8.60 cm (p = .43). Eight patients had ≥1 complication with SV I (n = 7), SV II (n = 2), and SV IIA (n = 7). These included infection (n = 4), migration (n = 3), pneumonia (n = 2), and instrumentation failure (n = 2). CONCLUSION At minimum two-year follow-up, GF surgical intervention for the treatment of EOS associated with Goldenhar syndrome trended toward improvements in scoliosis and spine height, but had a significant improvement in convex hemithoracic height; however, the majority of patients experienced severity grade I or II complications. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Braydon Connell
- Department of Medicine, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada; IWK Health Centre, 5980 University Ave, Halifax, NS B3K 6R8, Canada.
| | - Jonathan J Oore
- Department of Medicine, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada; IWK Health Centre, 5980 University Ave, Halifax, NS B3K 6R8, Canada
| | - Joshua M Pahys
- Shriner's Hospital, 3551 N Broad St, Philadelphia, PA 19140, USA
| | - George H Thompson
- Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Tricia St Hilaire
- Children's Spine Foundation, P.O. Box 397, Valley Forge, PA 19481, USA
| | - Tara Flynn
- Children's Spine Foundation, P.O. Box 397, Valley Forge, PA 19481, USA
| | - Ron El-Hawary
- Department of Medicine, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada; IWK Health Centre, 5980 University Ave, Halifax, NS B3K 6R8, Canada
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21
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Johns AL, Luquetti DV, Brajcich MR, Heike CL, Stock NM. In Their Own Words: Caregiver and Patient Perspectives on Stressors, Resources, and Recommendations in Craniofacial Microsomia Care. J Craniofac Surg 2018; 29:2198-2205. [PMID: 30334912 PMCID: PMC6224304 DOI: 10.1097/scs.0000000000004867] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study describes stressors, resources, and recommendations related to craniofacial microsomia (CFM) care from the perspective of caregivers of children with CFM and adults with CFM to inform improved quality of healthcare delivery. A mixed method design was used with fixed-response and open-ended questions from an online survey in English. The survey included demographics, CFM phenotypic information, and items about CFM-related experiences across settings. Themes were identified by qualitative analysis of responses to open-ended questions. Respondents (n = 51) included caregivers (n = 42; 90% mothers) and adults with CFM (n = 9; 78% female), who had a mean age of 45 ± 6 years. Most children were male (71%) with an average age of 7 ± 4 years. Respondents were primarily white (80%), non-Hispanic (89%), from the United States (82%), had a college degree (80%), and had private health insurance (80%). Reflecting the high rate of microtia (84%) in the sample, themes centered on the impact of hearing difficulties across settings with related language concerns. Negative social experiences were frequently described and school needs outlined. Multiple medical stressors were identified and corresponding suggestions included: providers need to be better informed about CFM, treatment coordination among specialists, and preference for a family-centered approach with reassurance, empathy, and clear communication. Advice offered to others with CFM included positive coping strategies. Overall, caregivers' and patients' responses reflected the complexity of CFM treatment. Incorporating these perspectives into routine CFM care has the potential to reduce family distress while improving their healthcare.
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Affiliation(s)
- Alexis L. Johns
- Division of Plastic and Maxillofacial Surgery; Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Daniela V. Luquetti
- Seattle Children’s Hospital, Craniofacial Center; Seattle Children’s Research Institute; University of Washington, Department of Pediatrics, Seattle, WA, USA
| | | | - Carrie L. Heike
- Seattle Children’s Hospital, Craniofacial Center; Seattle Children’s Research Institute; University of Washington, Department of Pediatrics, Seattle, WA, USA
| | - Nicola M. Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
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22
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Khan WA, Salim B, Khan AA, Chughtai S. Anaesthetic Management in a Child with Goldenhar Syndrome. J Coll Physicians Surg Pak 2017; 27:S6-S7. [PMID: 28302228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/16/2016] [Indexed: 06/06/2023]
Abstract
Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags. His developmental milestones were delayed. Airway evaluation showed Mallampati class II with limited movements of head and neck, which suggested possibility of difficult laryngoscopy and intubation. He had no vertebral anomalies or cardiac disease. A difficult airway continues to be a major cause of anaesthesia-related morbidity and mortality; and maintaining spontaneous breathing remains a vital technique in its management. Lack of anaesthesia-related complications with supraglottic devices encouraged us to present the advantage of utilising a laryngeal mask airway (LMA) under anaesthesia for successful management of predicted difficult airway.
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Affiliation(s)
- Waqas Ahmed Khan
- Department of Anaesthesia, The Aga Khan University Hospital, Karachi
| | - Bushra Salim
- Department of Anaesthesia, The Aga Khan University Hospital, Karachi
| | - Ausaf Ahmed Khan
- Department of Anaesthesia, The Aga Khan University Hospital, Karachi
| | - Shakaib Chughtai
- Department of Anaesthesia, The Aga Khan University Hospital, Karachi
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23
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Zhou AX, Ambati BK. Sutureless Lamellar Corneoscleral Patch Graft With Fibrin Sealant for Limbal Dermoid Removal. J Pediatr Ophthalmol Strabismus 2016; 53 Online:e22-5. [PMID: 27281829 DOI: 10.3928/01913913-20160509-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/25/2016] [Indexed: 11/20/2022]
Abstract
A 2-year-old boy with Goldenhar syndrome had a limbal dermoid removed and covered with a lamellar corneoscleral patch graft that was attached with fibrin glue and no sutures. The graft healed and attached well. A sutureless technique is beneficial due to decreased scarring and chance of infection.
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Luo E, Yang S, Du W, Chen Q, Liao C, Fei W, Hu J. Bimaxillary Orthognathic Approach to Correct Skeletal Facial Asymmetry of Hemifacial Microsomia in Adults. Aesthetic Plast Surg 2016; 40:400-9. [PMID: 26908014 DOI: 10.1007/s00266-015-0590-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 11/13/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hemifacial microsomia (HFM) is the second most common congenital craniofacial deformity after cleft lip and palate. Distraction osteogenesis (DO) is regarded as an alternative and efficient treatment option for patients with HFM. However, DO was not proven effective for all cases, and the results of long-term follow-up were not satisfactory as expected. Compared with DO, the orthognathic surgery approach may offer more stable clinical outcomes for this kind of disease. The purpose of this study is to evaluate the long-term clinical and radiographic outcome of bimaxillary orthognathic surgery in the treatment of adult HFM. METHODS Eight patients with HFM who had undergone bimaxillary orthognathic surgery between 2008 and 2012 were included in the study. The surgical procedures included Le Fort I osteotomy, inverted-L osteotomy, sagittal split ramus osteotomy, genioplasty, and iliac bone grafting. Pre- and postoperative orthodontic treatments were performed, respectively. Clinical and radiographic examinations were carried out to assess postoperative outcomes. RESULTS No obvious complications appeared postoperatively and no recurrences occurred during follow-up. All patients obtained satisfactory aesthetic results. Marked improvement in facial contour and occlusion were observed. Plain radiographs showed that the height ratios between the affected and unaffected ramus were ameliorated significantly. CONCLUSION The bimaxillary orthognathic approach to correct the deformity of adult HFM can obtain stable results in the long-term follow-up, and should be considered as a priority method for the treatment of adult patients with dentofacial deformity. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- En Luo
- West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Shimao Yang
- West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Wen Du
- West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Qianming Chen
- West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Chuhang Liao
- Department of Stomotology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China
| | - Wei Fei
- Department of Stomotology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China.
| | - Jing Hu
- West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China.
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Abstract
We present a case of a 13-year-old boy with clinical features of Goldenhar syndrome (hemifacial microsomia with malformed ears) and associated contralateral pulmonary aplasia. The patient did not have any associated respiratory symptoms. Pulmonary aplasia is an uncommon association of Goldenhar Syndrome. A case of contralateral pulmonary aplasia has been rarely reported in the literature to the best of our knowledge.
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Affiliation(s)
| | - Jyoti Kumar
- Department of Radiodiagnosis, Lok Nayak Hospital, New Delhi, India
| | - Swati Gupta
- Department of Radiodiagnosis, Lok Nayak Hospital, New Delhi, India
| | - Anju Garg
- Department of Radiodiagnosis, Lok Nayak Hospital, New Delhi, India
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26
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Khawaja SN, Crow H, Gonzalez Y. Goldenhar Syndrome and Pain-Related Temporomandibular Disorders. A Case Report. N Y State Dent J 2016; 82:21-24. [PMID: 27348947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Goldenhar syndrome (GS) is a development syndrome, characterized by incomplete development of the craniofacial region. The involvement is mainly unilateral; it varies from being mild to severe; and it can range from malocclusion and facial asymmetry to a more complex phenotype with complete absence of the mandibular ramus and temporomandibular joint. However, orthopedic symptoms of orofacial pain and dysfunction have not generally been considered as part of the symptom complex in GS cases. The case presented here is of a 15-year-old Caucasian patient, who was referred for evaluation because of bilateral pain in the masticatory muscles and temporomandibular joints.
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27
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Vitković B, Milić M. AIRWAY MANAGEMENT WITH DIRECT LARYNGOSCOPY IN A CHILD WITH GOLDENHAR SYNDROME. Acta Clin Croat 2016; 55 Suppl 1:90-93. [PMID: 27276779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Goldenhar syndrome, also known as oculoauriculovertebral dysplasia, is a rare congenital condition characterized by facial, cranial, vertebral, ocular, auricular and cardiac abnormalities. This syndrome is associated with hemifacial microsomia due to inadequate growth of the mandible and vertebral anomaly of the cervical part of the spine. For anesthesiologists, airway management is of great interest because of facial and oral abnormalities such as mandibular hypoplasia and limitation of neck movement. Considering different conditions of Goldenhar syndrome, every patient should be preoperatively evaluated in order to make the plan for the anticipated difficult airway management. We report a case of a 2.5-year-old boy undergoing palatoplasty, who required general anesthesia and orotracheal intubation. Our decision to intubate with direct laryngoscopy and with slight external pressure on the larynx proved successful.
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28
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L'Heureux-Lebeau B, Saliba I. Anteverted internal auditory canal as an inner ear anomaly in patients with craniofacial microsomia. Int J Pediatr Otorhinolaryngol 2014; 78:1551-3. [PMID: 25002156 DOI: 10.1016/j.ijporl.2014.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 06/03/2014] [Accepted: 06/05/2014] [Indexed: 11/19/2022]
Abstract
Craniofacial microsomia involves structure of the first and second branchial arches. A wide range of ear anomalies, affecting external, middle and inner ear, has been described in association with this condition. We report three cases of anteverted internal auditory canal in patients presenting craniofacial microsomia. This unique internal auditory canal orientation was found on high-resolution computed tomography of the temporal bones. This internal auditory canal anomaly is yet unreported in craniofacial anomalies.
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Affiliation(s)
- Bénédicte L'Heureux-Lebeau
- Division of Otorhinolaryngology Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Montreal, Quebec, Canada
| | - Issam Saliba
- Division of Otorhinolaryngology Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Montreal, Quebec, Canada.
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29
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Damen S, Janssen MJ, Huisman M, Ruijssenaars WAJJM, Schuengel C. Stimulating intersubjective communication in an adult with deafblindness: a single-case experiment. J Deaf Stud Deaf Educ 2014; 19:366-384. [PMID: 24688067 DOI: 10.1093/deafed/enu006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sensory disabilities may limit a person's development of intersubjectivity, that is, the awareness of self and other, which develops in conjunction with interpersonal communication. This study used intersubjectivity theory to test a new intervention called the High-Quality Communication (HQC) intervention for its effects on a young adult with congenital deafblindness and a developmental age of between 1.5 and 4 years. Three of his social partners were trained to support attunement and meaning making with him through education and video feedback. This study measured seven observation categories at three layers of intersubjective development during a baseline and two intervention phases: dyadic interaction, shared emotion, referential communication, meaning negotiation, shared meaning, declarative communication, and shared past experience. The participant's use of conventional communication was included as an additional category. Effects were observed in all observation categories from the baseline to the intervention phases. Further study of the effectiveness of the HQC intervention is recommended to test whether effects generalize across people and settings.
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30
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Cingano L, Cohen E, Cohen A, Giordanetto J, Loria P, Calcagno E. Odontostomatological aspects in patients with Goldenhar syndrome: a series of 9 patients. Minerva Stomatol 2013; 62:375-385. [PMID: 24217685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The authors observed and followed nine patients with Goldenhar syndrome to identify the variability and severity malformations mainly affecting the orofacial district, but also other systems. Considering the severity of the lesions and the affected organs and tissues, the authors report preventive and therapeutic approaches, which present considerable difficulties in timing and quality of interventions.
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Affiliation(s)
- L Cingano
- Section of Dentistry, Genoa Univerity, Genoa, Italy -
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Sasanuma H, Niwa Y, Shimada N, Machida M, Irei T, Hayashi K, Takeuchi M. [Tracheal intubation using Airtraq optical laryngoscope in an adult patient with Goldenhar syndrome]. Masui 2013; 62:867-869. [PMID: 23905414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 23-year-old woman with Goldenhar syndrome and conductive deafness was scheduled for tympanoplasty. Goldenhar syndrome is a developmental disorder characterized by ear malformation, mandibular hypoplasia, and vertebral anomalies. Furthermore, she had micrognathia, trismus, and mandibular hypoplasia. Awake taracheal intubation was attempted to prevent airway obstruction, because we had anticipated her difficult airway (micrognathia, trismus, and mandibular hypoplasia). The vocal cords were visualized with a Cormac and Lehane grade I, using the Airtraq optical laryngoscope Small (Size 2), under sedation. Then, an endotracheal tube was inserted after induction of general anesthesia. This is the first case report on the successful orotracheal intubation using Airtraq in an adult with Goldenhar syndrome.
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Affiliation(s)
- Hiromi Sasanuma
- Moka 321-4306 Department of Anesthesiology, Haga Red Cross Hospital, Moka 321-4306
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Patil MB, Patil SM. Facio-auriculo-vertebral sequence in association with congenital hypoparathyroidism. Indian Pediatr 2012; 49:670-672. [PMID: 22962243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although, Facio-auriculo-vertebral sequence (FAVS) is a well recognized condition with cranio-facial, ocular and vertebral anomalies, extreme variability of expression is characteristic. Association of cardiac, CNS, lungs, kidneys and limb defects are described. We report a neonatal case with FAVS in association with congenital hypoparathyroidism.
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Aydogan MS, Begec Z, Erdogan MA, Yücel A, Ersoy MO. Airway management using the ProSeal laryngeal mask airway in a child with Goldenhar syndrome. Eur Rev Med Pharmacol Sci 2012; 16:559-561. [PMID: 22696887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Children with congenital anomalies such as Goldenhar syndrome affecting the airway can be a problem for the anaesthesiologist. We present the case of an 18 month-old child with Goldenhar syndrome, in whom the ProSeal Laryngeal Mask Airway was successfully used for inguinal hernia surgery.
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Affiliation(s)
- M S Aydogan
- Department of Anaesthesiology and Reanimation, Medical Faculty, Inonu University, Malatya, Turkey
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Shrestha UD, Adhikari S. Goldenhar syndrome in association with Duane syndrome. JNMA J Nepal Med Assoc 2012; 52:33-35. [PMID: 23279771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Goldenhar syndrome (GHS) is also known as Oculo-Auriculo-Vertebral (OAV) syndrome or Branchial arch syndrome. Duane retraction syndrome (DRS) is a congenital disorder of ocular motility characterized by limited abduction, adduction or both. It is unilateral in 80% of cases. The important and interesting part of this eight months old child is presence of GHS with DRS. She has bilateral invol-vement, which is seen in only 5-8% of GHS, as compared to high incidence of unilateral involve-ment. This child also had refractive error of + 6.00/ - 1.5 * 180. At four year of age her vision with glass was 6/9. Children with GHS and DRS should have early eye examination done to treat the problem of refractive error.
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Affiliation(s)
- U D Shrestha
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
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Jin L, Hao S, Fu Y, Zhang T, Wang Z. Clinical analysis based on 208 patients with microtia (especially reviewed oculo-auriculo-vertebral spectrum, hearing test, CT scan). Turk J Pediatr 2010; 52:582-587. [PMID: 21428189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Microtia is a common birth defect and characteristic of abnormal auricle. It can be isolated or occur as a part of syndromes involving the first and second bronchial arch structures, such as oculo-auriculo-vertebral spectrum. We conducted a careful review of the literature regarding the clinical features of patients with microtia, but found few studies with respect to the Chinese population. In this study, we explored the clinical features of a single clinic population of 208 Chinese individuals with microtia. It showed that 15 cases (7.2%) had been afflicted with middle ear cholesteatoma, which would have brought about risky complications without an immediate removal; that 12 of 68 contralateral, normal-appearing ears had presented mild to moderate conductive or combined hearing loss (21-70 dB); that the degree of hearing loss deteriorated as the grade of microtia increased, with significant differences between grades I and III (p < 0.05); and that there was a male predominance, with the right side more likely to be affected.
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Affiliation(s)
- Lei Jin
- Department of Otorhinolaryngology, Head and Neck Surgery, Eye and ENT Hospital of Fudan University, Shanghai, China
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Al-Mulhim AN, Kamal HM. Ambiguous genitalia in neonates: a 4-year prospective study in a localized area. East Mediterr Health J 2010; 16:214-217. [PMID: 20799577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study aimed to determine the possible etiology ot ambiguous genitalia in 41 newborn intants at a referral hospital in Hofuf city, Saudi Arabia. In 46,XX karyotype patients (n 14), congenital adrenal hyperplasia and general malformation disorder were the most common causes of genital ambiguity, while in 46,XY karyotype patients (n=18), testosterone pathway biosynthetic defect was the most common cause even in conjunction with a generalized malformation disorder. In patients with abnormal karyotype (n=3), 1 had trisomy 18 (47,XX) and died after 3 months and 2 had different types of mosaic Turner syndrome. The karyotype was undetermined in 6 natients. Positive family history of ambiguous genitalia was noted in 4 patients.
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Affiliation(s)
- A N Al-Mulhim
- Department of Paediatrics, Maternity and Children Hospital, Hofuf, Saudi Arabia
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Ayuso Velasco R, Torres Aguirre A, Enríquez Zarabozo E, Galán Gómez E, Blesa Sánchez E. [Esophageal atresia in the Goldenhar syndrome]. Cir Pediatr 2010; 23:65-67. [PMID: 20578582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Among the multiple congenital defects associated to esophagueal atresia, the characteristic ones of the Goldenhar syndrome usually are not included. The high incidence has been reported, about 5% of esophagueal atresia in patients with Goldenhar syndrome. Our experience includes two patients with this association who presented anesthetic problems and surgical complications associated with gastroesophageal reflux and esophageal anastomosis.
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Affiliation(s)
- R Ayuso Velasco
- Servicio de Cirugía Pediátrica, Hospital Universitario Materno Infantil, Grupo de Investigación en Pediatría PAIDOS (CTS 019), Badajoz, SES, UEX.
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Clawson EP, Palinski KS, Elliott CA. Outcome of intensive oral motor and behavioural interventions for feeding difficulties in three children with Goldenhar Syndrome. ACTA ACUST UNITED AC 2009; 9:65-75. [PMID: 16352509 DOI: 10.1080/13638490500144809] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The facial anomalies and surgeries associated with Goldenhar Syndrome often lead to feeding problems. The purpose of this study was to demonstrate the outcome of Goldenhar Syndrome children admitted to the day patient paediatric feeding programme. SUBJECTS Three children with Goldenhar Syndrome and feeding difficulties participated, mean age 3 years. Average length of stay was 8 weeks. Upon admission all were dependent on tube feedings. METHODS The children received four therapeutic sessions daily. The sessions included oral motor interventions, behavioural techniques and a structured meal. Data regarding children's feeding were collected at admission and discharge. RESULTS The patients had 52% acceptance of food/drink at admission and 88.7% at discharge. Expels were 30% at admission and 14% at discharge. Mouth clean was 9.3% at admission and 97% at discharge. Total inappropriate feeding behaviours averaged 83% at admission and 27.3% at discharge. Children averaged 3.4 g per meal at admission and 105.4 g at discharge. Two children were completely weaned from tube feedings by discharge. CONCLUSIONS Results support the hypothesis that combining oral motor and behavioural interventions offer effective treatment for children with Goldenhar Syndrome. Many children with Goldenhar Syndrome are reliant on tube feedings and this regimen allows them to eat orally, thereby improving their nutrition and quality of life.
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Kourelis K, Gouma P, Naxakis S, Kalogeropoulou C, Goumas P. Oculoauriculovertebral complex with an atypical cause of obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 2009; 73:481-5. [PMID: 19111916 DOI: 10.1016/j.ijporl.2008.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 11/13/2008] [Accepted: 11/16/2008] [Indexed: 11/17/2022]
Abstract
Oculoauriculovertebral spectrum (OAVS) is a birth defect of unknown etiology, often causing obstructive sleep apnea, due to unilateral retrognathia. We describe an adolescent sleep apnea patient, with usual and unusual signs of OAVS. Apart from mandibular hypoplasia, microtia, external auditory canal atresia and cervical vertebrae anomalies, skull base asymmetry was also noted, resulting in aberrant anatomy of the tympanic cavity, and nasopharyngeal obstruction, which was the main source of the patient's apneas. The extended craniofacial abnormalities manifested here, suggest a broader developmental impairment, exceeding the 1st and 2nd branchial arch malformation theory, which is the principal hypothesis for OAVS etiology.
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Affiliation(s)
- Konstantinos Kourelis
- Department of Head and Neck Surgery, University Hospital of Patras, Rio, Patras, Greece.
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Kerckoff Villanueva H, Retamoza B, Bautista A. [Diabetic mother's newborn with Goldenhar syndrome and cerebral malformations. Case report]. Ginecol Obstet Mex 2008; 76:691-694. [PMID: 19065822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Goldenhar syndrome, also known as oculo-auriculo-vertebral syndrome, is a rare illness with unknown etiology. It happens in 1 of 50,000 newborns and is characterized by first and second brachial arch changes, with variable grades of hemifacial hypoplasia. We report a clinical case of a 39-years-old woman with a BMI of 33, family history of diabetes mellitus decease, and two fetal losses with unknown etiology. We first met patient at 24 gestational weeks. Second level ultrasound findings were: fetus with tri-ventricular obstructive hydrocephalia, symmetrical macrocranium, and occipital encephalocele. As her capilar glycaemia level was 197 to 338 mg/dL, diagnosis was gestational diabetes. Patient was scheduled to cesarian section and we obtain a newborn with: 2,050 g of weight, 45 cm of height, 38 cm of cephalic diameter, 6/7 Apgar score, and 33 gestational weeks (Capurro). Obesity and 2-type diabetes are well-known fetal malformation etiologies, due to insulin resistance. Maternal hyperglycemia causes oxidative stress in embryo cells, it changes Pax3 gene path, and causes several chromosomopaties and malformations; main perinatal mortality etiology, among them, are neural tube alterations. All together enable to establish this Goldenhar diagnosis: palpebral coloboma, facial asymmetry, external ear, upper hemivertebra, and microphthalmy.
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Horbelt CV. A review of physical, behavioral, and oral characteristics associated with Treacher Collins syndrome, Goldenhar syndrome, and Angelman syndrome. Gen Dent 2008; 56:416-419. [PMID: 18683396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Carlton V Horbelt
- Division of Pediatric and Community Oral Health, University of Tennessee College of Dentistry, Memphis, USA
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Abstract
Skeletal dysplasias are a heterogeneous group of disorders in which there is abnormal cartilage and bone formation, growth, and remodeling. There are more than 200 described skeletal dysplasias. Skeletal dysplasias can affect the spine in various ways, with attendant neurosurgical implications for diagnosis and treatment. Craniocervical junction abnormalities, atlantoaxial subluxation, and kyphoscoliotic deformity are among the common spinal problems that are found in certain skeletal dysplasias.
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Affiliation(s)
- Debbie Song
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI 48109-0338, USA
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Garcia de Paula e Silva FW, de Carvalho FK, Diaz-Serrano KV, de Freitas AC, Borsatto MC, de Queiroz AM. Solitary median maxillary central incisor in association with Goldenhar's syndrome: a case report. Spec Care Dentist 2007; 27:105-7. [PMID: 17658185 DOI: 10.1111/j.1754-4505.2007.tb01749.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Goldenhar's syndrome is a rare disorder characterized by several anomalies that include dermal epibulbar cysts, auricular appendices and malformations and vertebral anomalies. In this article, the authors report a case of Goldenhar's syndrome in a 10-year-old child who presented with the classical signs of this condition and a solitary median maxillary central incisor (SMMCI).
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Abstract
We report a case of difficult intubation in a child with Goldenhar syndrome and atypical plasma cholinesterase. Intubation attempts by direct laryngoscopy and the Trachlight were unsuccessful. The airway was ultimately secured using the pediatric GlideScope in conjunction with external laryngeal manipulation.
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Affiliation(s)
- Andrew D Milne
- Department of Paediatric Anaesthesia, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
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Abstract
A child with Goldenhar's syndrome, bilateral choroidal colobomas, and a morning glory anomaly of the optic disk in one eye is described. Bilateral posterior segment anomalies associated with Goldenhar's syndrome are rare. An association between the morning glory anomaly and Goldenhar's syndrome has not been previously reported.
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Affiliation(s)
- Zia Chaudhuri
- Department of Ophthalmology, Sir Ganga Ram Hospital, New Delhi, India
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Ottaviano G, Calzolari F, Martini A. Goldenhar syndrome in association with agenesia of the internal carotid artery. Int J Pediatr Otorhinolaryngol 2007; 71:509-12. [PMID: 17161873 DOI: 10.1016/j.ijporl.2006.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 11/01/2006] [Accepted: 11/01/2006] [Indexed: 11/29/2022]
Abstract
The association between Goldenhar syndrome and homolateral internal carotid artery agenesis to our knowledge, has never emerged before. We present a case report in a female child that was examined with tonal audiometry, A.B.R., CT scan, MR, digital-subtraction-angiography and color Doppler. The aim of this report is to present an uncommon pathologic association which also provides a brief review of the embryology of the ear and carotid vessels whilst discussing probable pathogenetic causes.
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MESH Headings
- Angiography, Digital Subtraction
- Audiometry, Pure-Tone/methods
- Carotid Artery Diseases/complications
- Carotid Artery Diseases/diagnosis
- Carotid Artery, Internal/abnormalities
- Carotid Artery, Internal/diagnostic imaging
- Carotid Artery, Internal/pathology
- Female
- Goldenhar Syndrome/complications
- Goldenhar Syndrome/diagnosis
- Hearing Loss, Conductive/complications
- Hearing Loss, Conductive/diagnosis
- Humans
- Infant, Newborn
- Magnetic Resonance Imaging
- Tomography, X-Ray Computed
- Ultrasonography, Doppler, Color
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Abstract
OBJECTIVE To report a case with Goldenhar syndrome with posterior urethral valves. METHODS Goldenhar syndrome (oculoauriculovertebral dysplasia) is a condition featuring the following triad of anomalies: ocular abnormalities (epibulbar dermoids, coloboma), otic anomalies (low set ears, auricular appendage) and/or vertebral anomalies. Multiple malformations, including congenital heart, brain and renal disease. RESULTS Posterior urethral valves should be treated with primary valve ablation. CONCLUSIONS It is necessary to perform a careful evaluations of general malformations, especially renal malformations.
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Affiliation(s)
- Alberto Palacios
- Servicio de Urología Pediátrica, Hospital María Pía, Porto, Portugal.
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Affiliation(s)
- Anne Greenough
- King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, Denmark Hill, London SE5 9PJ, UK.
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