Mosaic Trisomy

Figure 1.62. Another variant of the median cleft syndrome (holoprosen-cephaly) is cebocephaly in which there is a small nose with a single nostril above or below the eyes. Note the single orifice and aplasia of the nasal septum and philtrum.

Buccal Pad Fat Newborn Baby

Figure 1.63. Buccal fat pads (sucking cushions) are pads of fat tissue between the fibers of the masseter muscle. When the infant is sucking they prevent collapsing of the cheeks during indrawing. These fat pads remain unaltered despite loss of adipose tissue in other body areas.

Figure 1.64. Sucking blisters (sucking calluses) on the lips are present in the newborn infant. From birth, the lips show a sharp line of demarcation where the skin meets the mucosa. The mucosa is slightly elevated, moist, glistening deep red or purple and ends abruptly with the skin which forms one-third of the visible lip. The term "sucking calluses" is a misnomer because they are not callosities due to pressure or friction. They have been seen at their most florid in infants who have never sucked (for example those with congenital heart disease). Efficient sucking requires a complete seal of the lips around the nipple, hence the development of these calluses.

Sucking Blisters Infant

Figure 1.65. Another example of sucking blisters in an infant at 6 days of age. Note that the mucous membrane portion of the lip has a superficial furrowed appearance. With time, the outer layer dries with lifting and shedding of the cornified epithelium and new blisters may develop for a few weeks. They occur most commonly in breast-fed infants or babies who feed vigorously. Pathologically, this can also occur from overheated formula, or as an allergic reaction to the components of the nipple or the formula.

Philtrum Sinus

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Figure 1.66. A thin vermilion border of the upper lip in a normal infant. This may also be seen in many syndromes such as the fetal alcohol syndrome. A long philtrum may indicate a short nose and a short philtrum may indicate a long nose. Downturned corners of the mouth may reflect overgrowth in the width of the upper lip, which when combined with a short philtrum or thick lower lip results in a carp-like mouth.

Wat Bilateral Macrostomia

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Trisomy Mosaic Syndrome

Figure 1.67. This infant is an example of microstomia occurring as a result of excessive merging of the maxillary and mandibular processes of the mandibular arch. This may occur in normal infants or is associated with many syndromes such as Hallermann-Streiff syndrome and Freeman-Sheldon syndrome. The diagnosis in this infant was mosaic trisomy 8.

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Mosaic Trisomy

Figure 1.68. This infant with severe bilateral macrostomia is an example of a congenital lateral or transverse facial cleft which results from malformation of the mandibular arch (failure of the lateral maxillary and mandibular processes to merge). The defect may be unilateral or bilateral and is associated with deformities of the outer ear, hypoplasia of the mandible or maxilla, and cleft palate. It is also seen in Goldenhar's syndrome.

Figure 1.68. This infant with severe bilateral macrostomia is an example of a congenital lateral or transverse facial cleft which results from malformation of the mandibular arch (failure of the lateral maxillary and mandibular processes to merge). The defect may be unilateral or bilateral and is associated with deformities of the outer ear, hypoplasia of the mandible or maxilla, and cleft palate. It is also seen in Goldenhar's syndrome.

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Transverse Facial Cleft

Figure 1.69. A lateral view of the severe macrostomia in the same infant. Note the micrognathia. There were no other abnormalities. An oblique facial cleft (orbitofacial fissure) extends from the upper lip to the medial aspect of the orbit. It is often bilateral and may involve the orbit, nose, lacrimal ducts, or central nervous system. This may occur from facial clefting that results from swallowed amniotic bands and represents a disruption in that it does not follow the normal planes of fusion of the face.

Figure 1.69. A lateral view of the severe macrostomia in the same infant. Note the micrognathia. There were no other abnormalities. An oblique facial cleft (orbitofacial fissure) extends from the upper lip to the medial aspect of the orbit. It is often bilateral and may involve the orbit, nose, lacrimal ducts, or central nervous system. This may occur from facial clefting that results from swallowed amniotic bands and represents a disruption in that it does not follow the normal planes of fusion of the face.

Figure 1.70. Right-sided unilateral macrostomia in an otherwise normal infant.

Goldenhar Syndrome

Figure 1.71. This infant with Goldenhar's syndrome has unilateral macrostomia. There was an antimongoloid slant to the eyes, preauricular skin tags, and deafness.

Figure 1.72. Macrostomia with cutaneous tags and preauricular skin tags. Cutaneous pits and tags may be found along a line connecting the oral commissure and the external auditory canal in Goldenhar's syndrome.

Goldenhar Syndrome

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Goldenhar SyndromeEruption Cyst

Figure 1.73. Eruption cysts in an infant at birth. Note the central lower incisors which are visible. The teeth erupted at the age of 4 days.

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Eruption Cyst Newborn

Figure 1.74. In the upper figure, note the eruption cysts which were present at birth. At the age of 7 days, both lower central incisors had erupted (lower figure). Nearly all neonatal teeth arise from the normal deciduous complement and are usually only immature caps of enamel and dentine with poor root formation. Often the eruption cyst is present on the gum at birth and the neonatal tooth appears shortly afterwards. The lower central incisors are the most common site for neonatal teeth.

Mosial Trisomy

Figure 1.75. Natal teeth present at birth. Teeth that erupt after birth are neonatal teeth. These teeth have a familial pattern of occurrence and are more common in certain races such as American Indians and Eskimos. Neonatal teeth may occur in association with syndromes.

Figure 1.76. Note the poor development of this natal tooth. This should be extracted, as this may fall out spontaneously and be aspirated.

Figure 1.76. Note the poor development of this natal tooth. This should be extracted, as this may fall out spontaneously and be aspirated.

Mosaic Trisomy
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Responses

  • mewael
    How to tie a skin tag with a cartilage remedies?
    9 months ago
  • welde tewolde
    How to decrease crease of philtrun?
    3 months ago

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