Frontonasal Dysplasia

Also known as median cleft face syndrome, this condition results in a flat, wide nose and wide-set eyes. There is a groove down the middle of the face, and in some cases, the tip of the nose is missing. A gap with extra folds of skin covering it may appear on the front of the head.

Treatment of this disorder depends on the severity of the child's physical characteristics. Surgery may correct the divided nose, cleft lip, and other facial deformities. In some cases, more surgery may be needed as the child gets older.

A team approach for infants and children with this disorder may help, including special social, educational, and medical services.

Hemifacial Microsomia/Goldenhar Syndrome

In this condition, the lower half of one side of the face does not grow normally, leading to a missing or partially formed ear. In Goldenhar syndrome (a variant of hemifacial microsomia) benign growths of the eye may be accompanied by neck problems, which are most commonly caused by a fusion of bony bridges between the bones of the neck.

Due to the delayed growth and development of the lower half of the face, the effects of this syndrome will be more evident as the child grows. The lack of the development of the upper and lower jaws can cause breathing problems as well as a dental malocclusion, which will need to be addressed surgically and orthodontically. Treatment generally requires the expertise of both a craniofacial surgeon and an orthodontist.

The jaw deformity may be reconstructed as early as age three if the problem is severe enough to cause airway problems. The best approach to reconstructing the jaw is determined by the surgeon and is specific for each patient. If it is needed, ear reconstruction is performed in four stages, usually at age six. Throughout life, these patients must maintain adequate dental occlusion through ongoing orthodontic treatment.

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