Severe Mandibulofacial Dysostosis in Patient with Treacher Collins Syndrome

A 14-year-old female with a history of Treacher Collins syndrome, asthma, tracheostomy dependence, and sinusitis was referred for dental, orthodontic, and surgical treatment planning. The radiologist noted findings consistent with severe Treacher Collins syndrome, demonstrating marked mandibulofacial dysostosis with severe mandibular retrognathia and micrognathia, aplastic mandibular condyles with minimal ramus and glenoid fossa formation, absence or severe hypoplasia of the external ears and external auditory canals, and severe hypoplasia or aplasia of the zygomatic bones and zygomatic arches. The dentition was significantly affected, with severe malpositioning of the mandibular teeth, multiple missing mandibular teeth, and ectopic teeth, including one projecting along the right TMJ articular region.