Prenatal diagnosis and physical model reconstruction of agnathia-otocephaly with limb deformities (absent ulna, fibula and digits) following maternal exposure to oxymetazoline in the first trimester

J Obstet Gynaecol Res. 2016 Aug;42(8):1016-20. doi: 10.1111/jog.13014. Epub 2016 Apr 17.

Abstract

Agnathia-otocephaly or agnathia-sinotia-microstomy syndrome is the most severe malformation affecting the first branchial arch. It is a rare congenital anomaly characterized by absence of the lower jaw and abnormal ear positioning. Prenatal diagnosis is possible on conventional 2-D ultrasound in the second trimester. Three-dimensional ultrasound enhances detection of abnormal facial phenotype, especially in surface rendering mode. In addition, 3-D volume datasets are used to produce a physical model of the anomaly. We present a case of second trimester ultrasound diagnosis of agnathia-otocephaly associated with limb deformities. A physical model produced using 3-D ultrasound volume datasets facilitated better understanding of this congenital malformation, and improvement of parental counselling and management by the multispecialist team.

Keywords: agnathia-otocephaly; limb deformity; maternal exposure to oxymetazoline; physical model; three-dimensional ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Branchial Region / abnormalities
  • Branchial Region / diagnostic imaging
  • Craniofacial Abnormalities / diagnostic imaging*
  • Female
  • Fibula / abnormalities
  • Fibula / diagnostic imaging
  • Fingers / abnormalities
  • Fingers / diagnostic imaging
  • Humans
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional / methods
  • Maternal Exposure*
  • Nasal Decongestants / adverse effects*
  • Oxymetazoline / adverse effects*
  • Pregnancy
  • Pregnancy Trimester, First / drug effects
  • Pregnancy Trimester, Second
  • Ulna / abnormalities
  • Ulna / diagnostic imaging
  • Ultrasonography, Prenatal / methods*

Substances

  • Nasal Decongestants
  • Oxymetazoline

Supplementary concepts

  • Otocephaly