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Reconstructive Surgery / Treacher-Collins

Treacher-Collins Syndrome


Treacher-Collins Syndrome or mandibulofacial dysostosis is a genetically inherited condition which may vary in its facial deformity from mild to severe.

Treacher-Collins SyndromeIt manifests bilaterally (on both sides) to involve the eyes, cheek bones, external ears and lower jaw.

Dr. Paul Tessier (1917-2008), the father of modern craniofacial surgery, considered this condition a grouping of facial clefts or defects which resulted in:

  • A downward slant of the lateral (outer) eyes
  • Deficiencies of the malar (cheek) bones
  • Absent or malformed external ears
  • Deficiencies of the mandible (lower jaw) and other facial anomalies
  • A cleft lip and/or palate may also be present.

The UCLA Craniofacial Clinic Protocol for correction of Treacher-Collins may vary depending on the individual patient and the severity of the deformity. However, guidelines for timing of the procedures are as follows:

Before and After
Before After
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  1. 3 months: Repair of Cleft lip and/or 1 year: Repair of cleft palate; If airway obstruction is problematic as an infant, surgically procedures may be used for correction of this including: a tracheostomy, mandibular or hyoid advancement or another procedures.
  2. 6-8 years: Reconstruction of malar region-Zygomatic arch, lateral orbital wall and orbital floor with cranial bone graft and eyelid correction;
  3. 6-8 years: External ear reconstruction;
  4. 5-8 years: Mandibular lengthening with distraction osteogenesis using intraoral devices;
  5. 14-18 years (facial skeletal maturity) Orthognathic (Jaw) surgery
  6. 14-18 years(after jaw surgery): Septorhinoplasty, Laser removal of sideburn hair or other ancillary ('finishing') procedures.

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