Craniofacial Abnormalities

颅面畸形
  • 文章类型: Case Reports
    浮港综合征(FHS)是一种极为罕见的遗传疾病,与独特的面部外观有关,各种骨骼畸形,骨龄延迟,和表现性语言延迟。它是由Snf2相关的CREBBP激活蛋白(SRCAP)基因中的杂合突变引起的。本文的目的是描述一名14岁男性患有FHS的病例,参考文献综述,收集所有报告的症状。此外,描述了患者的正畸治疗。为此,电子数据库PubMed和Scopus使用关键字“浮动港综合征”进行搜索。与文献中以前的案例类似,患者身材矮小;三角形的脸,有一个大的球茎状的鼻子;深陷的眼睛和狭窄的眼睑间隙;宽口,上唇有细的朱红色边界;和背侧旋转,小耳朵他们还出现了一些描述较少的症状,如巨大牙体和小颌。此外,轻度智力低下,小头畸形,并发现精神运动发育延迟。在一个外传的基础上,口内检查,X光片,和CBCT,他被诊断为咬伤,I类犬和III类犬,在两边。据我们所知,到目前为止,这种疾病的正畸治疗尚未得到详细评估,所以这是第一种情况。
    Floating-Harbor syndrome (FHS) is an extremely rare genetic disorder connected with a distinctive facial appearance, various skeletal malformations, delayed bone age, and expressive language delays. It is caused by heterozygous mutations in the Snf2-related CREBBP activator protein (SRCAP) gene. The aim of this paper is to describe the case of a 14-year-old male with FHS, referring to a review of the literature, and to collect all reported symptoms. In addition, the orthodontic treatment of the patient is described. For this, the electronic databases PubMed and Scopus were searched using the keyword \"Floating-Harbor syndrome\". Similar to previous cases in the literature, the patient presented with short stature; a triangular face with a large bulbous nose; deep-set eyes and narrow eyelid gaps; a wide mouth with a thin vermilion border of the upper lip; and dorsally rotated, small ears. They also presented some less-described symptoms, such as macrodontia and micrognathia. Moreover, mild mental retardation, microcephaly, and delayed psychomotor development were found. On the basis of an extraoral, intraoral examination, X-rays, and CBCT, he was diagnosed with overbite, canine class I and angle class III, on both sides. To the best of our knowledge, orthodontic treatment of this disease has not been assessed in detail so far, so this is the first case.
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  • 文章类型: Case Reports
    背景:额鼻突发育不良(FND)是一种罕见的先天性异常,由额鼻突发育不足引起,它可以是综合征或非综合征。FND的典型特征包括畸形的鼻子和眼睛近视,有时与唇裂和/或腭裂有关。在过去的30年中,仅报告了大约10例产前诊断为非综合征性FND的病例。
    方法:一名33岁女性(G2P1)在妊娠20周时因双侧脑积水被转诊到我们中心。我们检测到了FND的典型特征,包括严重的听力亢进,正中鼻双向度,轻微的唇裂,和使用三维(3D)超声的多个肢体异常。胼胝体发育不良,单侧小生症,还发现了室间隔缺损。基因检测,包括核型分析,拷贝数变异(CNV)分析,三全外显子组测序(trio-WES),和三全基因测序(trio-WGS),执行;然而,与父母相比,我们在胎儿中没有发现任何从头基因变异。尸检证实了FND的产前诊断。
    结论:本病例扩大了产前FND患者的广泛表型范围。3D超声是检测面部和肢体畸形的有用工具。
    BACKGROUND: Frontonasal dysplasia (FND) is a rare congenital anomaly resulting from the underdevelopment of the frontonasal process, and it can be syndromic or nonsyndromic. The typical features of FND include a deformed nose and ocular hypertelorism, which are sometimes associated with cleft lip and/or palate. Only approximately 10 cases of prenatally diagnosed nonsyndromic FND have been reported in the past 30 years.
    METHODS: A 33-year-old woman (G2P1) was referred to our center at 20 gestational weeks for bilateral hydrocephaly. We detected typical features of FND, including severe hypertelorism, median nasal bifidity, a minor cleft lip, and multiple limb anomalies using three-dimensional (3D) ultrasound. A hypoplastic corpus callosum, unilateral microtia, and a ventricular septal defect were also detected. Genetic testing, including karyotype analysis, copy number variation (CNV) analysis, trio-whole exome sequencing (trio-WES), and trio-whole-gene sequencing (trio-WGS), was performed; however, we did not find any de novo gene variants in the fetus as compared to the parents. Postmortem examination confirmed the prenatal diagnosis of FND.
    CONCLUSIONS: The present case expands the wide phenotypic spectrum of prenatal FND patients. 3D ultrasound is a useful tool for detecting facial and limb deformities.
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  • 文章类型: Journal Article
    Schinzel-Giedion综合征(SGS)是一种严重的多系统疾病,其特征是独特的面部特征,严重的智力残疾,难治性癫痫,皮质视觉障碍,听力损失,和各种先天性异常。SGS归因于SETBP1基因中的功能获得(GoF)变体,报道的变体导致位于编码SETBP1残基aa868-871(degron)的12bp热点区域内的经典SGS。这里,我们描述了一个典型的SGS由一个新的杂合错义变体引起的案例,D874V,毗邻德格隆。该女性患者在新生儿期被诊断出,并表现出特征性的面部表型(面部中缩,突出的前额,和低设定的耳朵),双侧对称马蹄内翻足,重叠的脚趾,严重的双侧肾积水伴有先天性心脏病,与标准SGS一致。这是典型的SGS引起的第一份报告,SETBP1非degron错觉变体。此案例扩展了SGS的遗传谱,并为基因型-表型相关性提供了新的见解。
    Schinzel-Giedion syndrome (SGS) is a severe multisystem disorder characterized by distinctive facial features, profound intellectual disability, refractory epilepsy, cortical visual impairment, hearing loss, and various congenital anomalies. SGS is attributed to gain-of-function (GoF) variants in the SETBP1 gene, with reported variants causing canonical SGS located within a 12 bp hotspot region encoding SETBP1 residues aa868-871 (degron). Here, we describe a case of typical SGS caused by a novel heterozygous missense variant, D874V, adjacent to the degron. The female patient was diagnosed in the neonatal period and presented with characteristic facial phenotype (midface retraction, prominent forehead, and low-set ears), bilateral symmetrical talipes equinovarus, overlapping toes, and severe bilateral hydronephrosis accompanied by congenital heart disease, consistent with canonical SGS. This is the first report of a typical SGS caused by a, SETBP1 non-degron missense variant. This case expands the genetic spectrum of SGS and provides new insights into genotype-phenotype correlations.
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  • 文章类型: Journal Article
    先天性中线宫颈left裂是一种罕见的异常,被归类为the弓畸形,占先天性宫颈畸形的不到2%。其临床表现涉及宫颈中线畸形:头部结节性病变,具有萎缩性表面的线性凹槽,和/或尾窦。还可以存在可变复杂度的其他中线改变。早期治疗可以避免长期并发症。根据我们在四个临床病例中的经验,在过去的二十年中,对该主题进行了文献检索,以及随后对所采用的手术方法的讨论,我们纳入了150例报告病例.正确的诊断和早期治疗以及完全去除纤维中线带对于避免患者直到青春期或成年期的抱怨至关重要。
    Congenital midline cervical cleft is a rare anomaly classified as a malformation of the branchial arches and represents less than 2% of congenital cervical malformations. Its clinical presentation involves cervical midline deformities: cephalic nodular lesion, linear groove with atrophic surface, and/or caudal sinus. Other midline alterations of variable complexity may also be present. Early treatment allows for avoiding long-term complications. Based on our experience in four clinical cases, a performed literature search on the topic in the last twenty years, and subsequent discussion of the employed surgical approaches, we included 150 reported cases in our review. Correct diagnosis and early treatment with complete removal of the fibrous midline band is paramount to avoid patient complaints until adolescence or adulthood.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    目的:本研究旨在通过大型病例系列分析筋膜锚定缝合技术进行耳前瘘切除术的安全性和有效性。此外,根据术前状态和年龄调查了手术结局的差异.
    方法:在这项回顾性研究中,380例(450耳)患有耳前瘘(PAF)的患者,由一名外科医生使用筋膜锚定缝合技术进行了耳前瘘切除术(E。P)登记。患者被分为新鲜,先前的切口和引流(I&D),并根据术前状态进行翻修手术组。此外,根据年龄分为成人组和儿童组。病人的人口统计学,术后感染,并对复发率进行分析。
    结果:患者的平均年龄为28.3岁,男性119人,女性261人。在450个PAF中(新鲜组中n=281,在以前的I&D组中,n=119,并且在修订组中n=50),术后感染21例(4.7%),复发12例(2.7%)。术后感染没有差异,无论术前情况如何(I&D组,p=0.701;修订组,p=0.658)。翻修组的复发率高于新鲜组和I&D组(p=0.004)。成人和儿童术后感染(p=0.221)或复发(p=0.161)无显著差异。
    结论:该研究发现,使用筋膜锚定缝合技术进行耳前瘘切除术导致术后感染率和复发率较低。这些积极的结果在不同的患者组中是一致的,按术前状态和年龄分类。表明该技术对所有耳前瘘患者的安全性和有效性。
    OBJECTIVE: This study aimed to analyze the safety and efficacy of preauricular fistulectomy with fascia-anchoring suture technique through large case series. In addition, differences in surgical outcomes according to preoperative status and age were investigated.
    METHODS: In this retrospective study, 380 patients (450 ears) with preauricular fistula (PAF) who underwent preauricular fistulectomy with fascia-anchoring suture technique by a single surgeon (E.P) were enrolled. Patients were divided into fresh, previous incision and drainage (I&D), and the revision surgery groups according to the preoperative status. Additionally, they were divided into adult and pediatric groups according to age. Patient\'s demographics, postoperative infections, and recurrence rates were analyzed.
    RESULTS: The mean age of the patients was 28.3 years, and there were 119 males and 261 females. Out of 450 PAFs (n = 281 in the fresh groups, n = 119 in the previous I&D groups, and n = 50 in the revision groups), 21 (4.7 %) cases had postoperative infections and 12 (2.7 %) cases had recurrence. There was no difference in postoperative infections, regardless of the preoperative condition (I&D group, p = 0.701; revision group, p = 0.658). The recurrence rate was higher in the revision group than in the fresh and I&D groups (p = 0.004). There was no significant difference in postoperative infection (p = 0.221) or recurrence (p = 0.161) between adults and children.
    CONCLUSIONS: The study found that performing preauricular fistulectomy with a fascia-anchoring suture technique led to low rates of postoperative infections and recurrences. These positive outcomes were consistent across different patient groups categorized by preoperative status and age, indicating the technique\'s safety and effectiveness for all patients with preauricular fistulas.
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  • 文章类型: Case Reports
    马歇尔综合征是一种极其罕见的遗传性疾病,通常在婴儿期诊断,患病率<1/100万。在文献综述的基础上,这是首例提供Marshall综合征(从出生到12.5岁)儿童纵向病史的病例报告.这份纵向病例报告部分源于这个孩子的父母希望分享他们在最初诊断时的早期恐惧的故事,并将这些恐惧与她的表现进行比较。
    Marshall syndrome is an extremely rare genetic disorder usually diagnosed in infancy with a prevalence of <1 in 1 million. Based on the literature reviewed, this is the first case report to provide a longitudinal history of a child with Marshall syndrome (from birth to age 12.5 years). This longitudinal case report arose in part from desires of this child\'s parents to share the story of their early fears at her initial diagnosis and compare those to how well she has turned out.
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  • 文章类型: Case Reports
    背景:Zimmermann-Laband综合征(ZLS)和婴儿全身性透明症(ISH)是罕见的遗传性疾病。它们的特征在于各种光谱表现。尽管有其他病例报告,该病例由口腔医学专家和口腔颌面外科医师报告。
    方法:在本研究中,我们报道了一名18个月大的牙龈过度生长女性患者.这种现象完全嵌入了所有萌出的牙齿。在这种情况下,多发性丘疹性皮肤病变的存在是一个新观察到的方面,在现有文献中很少报道。在全身麻醉下切除牙龈过度生长。在手术后六个月的随访中,咀嚼和呼吸问题得到改善。在牙龈外观方面改善了美学方面。
    结论:迄今为止,由于模棱两可的介绍,这两种综合症对于专家来说仍然是一个谜。及时的诊断对于预后和防止严重的进一步附加费至关重要。牙医可以在罕见疾病的诊断中发挥重要作用。
    Zimmermann-Laband Syndrome (ZLS) and infantile systemic hyalinosis (ISH) are rare genetic disorders. They are characterized by various spectrum manifestations. In spite of other case reports, this case with features of both syndromes was reported by oral medicine specialists and oral and maxillofacial surgeons.
    In this study, we reported an 18-months old female patient with gingival overgrowth. This phenomenon completely embedded all the erupted teeth. In this case, the presence of multiple papulonodular cutaneous lesions is a newly observed aspect that has rarely been reported in the existing literature. Gingival overgrowth was excised under general anesthesia. At six months of follow-up after surgery, mastication and breathing problems were improved. Aesthetic aspects were ameliorated in terms of gingival appearance.
    To date, due to the ambiguous presentations, both syndromes remain an enigma for specialists. A timely diagnosis could be crucial for prognosis and preventing severe further surcharge. Dentists could play an important role in the diagnosis of rare disorders.
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  • 文章类型: Case Reports
    Pyknodysososis是一种罕见的遗传性疾病,其特征是骨骼和颅面异常。它是由编码组织蛋白酶K的基因突变引起的常染色体隐性遗传疾病。Pyknodysosis与身材矮小有关,脆骨,和独特的面部特征。
    方法:本病例报告呈现临床表现,诊断挑战,和一个8岁男性的治疗策略,一种极其罕见的以骨骼和颅面异常为特征的遗传性疾病。病人的临床表现,射线照相结果,基因检测结果,并对治疗方法进行了讨论。此外,强调遗传咨询和多学科护理在治疗这种疾病中的重要性.
    涉及骨科的多学科方法,遗传学,牙科,心理支持对于治疗骨性骨痛患者至关重要。定期随访,仔细监测骨折,适当的干预措施可以提高患者的生活质量,减少并发症。
    结论:早期识别的重要性,基因检测,多学科护理强调有效的治疗和支持。需要进一步的研究来增强我们对这种罕见的遗传性疾病的理解,并开发有针对性的治疗方法。
    UNASSIGNED: Pyknodysostosis is a rare genetic disorder characterized by skeletal and craniofacial abnormalities. It is an autosomal recessive disorder caused by mutations in the gene encoding cathepsin K. Pyknodysostosis is associated with short stature, brittle bones, and distinctive facial features.
    METHODS: This case report presents the clinical manifestations, diagnostic challenges, and management strategies of an 8-year-old male with pyknodysostosis, an extremely rare genetic disorder characterized by skeletal and craniofacial abnormalities. The patient\'s clinical presentation, radiographic findings, genetic testing results, and treatment approach are discussed. Additionally, the importance of genetic counseling and multidisciplinary care in managing this condition is emphasized.
    UNASSIGNED: A multidisciplinary approach involving orthopedics, genetics, dentistry, and psychological support is crucial for managing patients with pyknodysostosis. Regular follow-up visits, careful monitoring of fractures, and appropriate interventions can improve the patient\'s quality of life and reduce complications.
    CONCLUSIONS: The importance of early recognition, genetic testing, and multidisciplinary care is emphasized for effective treatment and support. Further research is needed to enhance our understanding of this rare genetic disorder and develop targeted therapies.
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