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She was microcephalic (head circumference 48.1 cm, −2.0 SDS), with a round face, up-slanting palpebral fissures, severe bilateral ptosis of eyelids (also noted in her paternal grandmother), bilateral epicanthic folds, flat and wide nasal bridge, small and widely spaced teeth, normal hand and foot length, bilateral hallux valgus, and cutis marmorata.
Like her sister, she had mild trigonocephaly, a high wide nasal bridge, almond shaped eyes, thickened gums and widely spaced teeth.
Dysmorphological features were significant for the following: convex eye globes, abnormal palpebral (down) slant, hypertelorism, wide nasal bridge, flat philtrum, thin upperlip, micro-and-retrognathia and nuchal wideness.
Observation revealed slight dropping of the nasal tip, a wide nasal width, and the presence of nasal septal deviation (Fig. 1a).
Fig. 1 a Preoperative evaluation prior to initial rhinoplasty demonstrating drooping of the nasal tip, wide nasal width, and nasal septal deviation.
While performing a lateral nasal wall osteotomy during a rhinoplasty, an intentional fracture is produced and the fractured segments are medialized to narrow a wide nasal base.
Similar(50)
Sexual dimorphism of the skull is more pronounced than in corsac foxes, with female red foxes tending to have smaller skulls than males, with wider nasal regions and hard palates, as well as having larger canines.
Even by stage 3, the male already has a wider nasal boss than the female, and the single stage 2 skull of male cottoni has wider nasals than the two corresponding stage females.
AD HIES is characterized by typical dysmorphic features such as facial asymmetry, prominent forehead, deep-set eyes, broad nasal bridge, wide fleshy nasal tip, high-arched palate, and mild prognathism that become apparent in late puberty (Fig. 2b) [ 26].
Her phenotypes included feeding difficulties in infancy, developmental delay, seizures, microcephaly, strabismus, hypertelorism, a low hairline, ear malformations, a broad nasal bridge, wide mouth, thick lips, and prominent incisors.
Common features in early childhood included fine sparse hair, epicanthic folds, wide depressed nasal bridge, broad nasal tip, and a prominent chin.
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