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The Goldenhar syndrome: a natural history
Insights
Goldenhar syndrome (1st branchial arch syndrome) presents varied challenges across age groups, from infancy ocular and palatal issues to adult spinal concerns. Early intervention and management are key for addressing hearing deficits and cosmetic concerns throughout life.
Area of Science:
- Genetics and Developmental Biology
- Pediatric Medicine
- Otolaryngology
Background:
- The 1st branchial arch syndrome, also known as Goldenhar syndrome, is a complex congenital disorder.
- It affects multiple craniofacial structures and can have systemic implications.
Purpose of the Study:
- To describe the diverse clinical manifestations and age-dependent challenges in a cohort of 24 patients with Goldenhar syndrome.
- To highlight previously unreported features and long-term outcomes.
Main Methods:
- Ascertainment of 24 patients with Goldenhar syndrome.
- Longitudinal observation of clinical features across different age groups (infancy to adulthood).
Main Results:
- Infancy: Ocular, auricular, and palatal issues are prominent; feeding difficulties (deglutition incoordination, achalasia, hiatus hernia, mobile cecum) are significant.
- Childhood/Adolescence: Hearing deficits and cosmetic concerns become more critical.
- Adulthood: Spinal problems with early degenerative changes requiring surgical intervention emerge.
- Fertility and longevity appear unaffected in this cohort.
Conclusions:
- Goldenhar syndrome exhibits a wide spectrum of age-related clinical challenges.
- Early identification and management of specific issues are crucial for patient outcomes.
- Unreported gastrointestinal and spinal complications require further attention.
Abstract:
Twenty-four patients with the 1st branchial arch (Goldenhar) syndrome have been ascertained ranging in age from newborn to 58 years. In infancy, the ocular, auricular, and palatal problems appear most prominent. In childhood, the correction of, or compensation for, hearing deficit assumes greater importance. Incoordination of deglutition, achalasia of the esophagus, hiatus hernia, and mobile cecum (hitherto unreported features) are characteristically troublesome in infancy and early childhood. Cosmetic problems though significant throughout, engender particular concern during adolescence and early adulthood. Spinal problems with early vertebral degenerative changes cause clinical difficulty requiring surgery during adulthood. Fertility appeared to be unimpaired and longevity is probably unaffected (although our oldest patient is less than 60 years old). Only three cases were mentally subnormal and none died following ascertainment.
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