Oculodentodigital Syndrome

Very rare form of bone dysplasia characterized by microphthalmia, microsomia, large jaw, and hypoplasia of the dental enamel. Other possible features are syndactyly or clinodactyly and glaucoma.

Oculo-Dento-Osseous Dysplasia; ODOD Syndrome.

Only a few cases reported.

First described in 1964 by F.D. Gillepsie in a brother and sister.

Two modes of transmission: autosomal dominant for the common form and autosomal recessive for the severe form. The gene responsible for the disease is mapped to the long arm of chromosome 6.

Unknown.

On radiographs the skull shows enlargement of the mandible and osteosclerosis of the skull. The orbits and basal ganglia may exhibit calcification. Other findings include widening of the metaphyses and cortical thickening of the tubular bones. Based on clinical picture and family history; however, many cases are new mutations.

Facial Appearance: Long, thin nose with hypoplasia of alae nasi and anteverted nostrils; may have cleft lip or palate. Ocular Anomalies: Microphthalmia, short palpebral fissures, epicanthal folds and microcornea. The presence of open-angle glaucoma has been reported as a late complication in 20% of patients. Dental: Enamel dysplasia with loose or brittle teeth. Limb Anomalies: Syndactyly, camptodactyly. Skeletal: Widespread osseous anomalies; mandibular overgrowth or micrognathia; broad clavicles and long bones. Central Nervous System: Intelligence is usually normal, but patients may have dysarthria, ataxia, or paraparesis. In the autosomal recessive type, calcification of basal ganglia, dilated ventricles, and the presence of more severe skeletal involvement (e.g., spinal cord compression from enlarged C1 vertebra) has been reported.

It is recommended to check the teeth condition. In case of severe skeletal involvement, CT scan of the brain and cervical spine should be obtained. An ophthalmologic examination to exclude glaucoma must be performed.

Teeth are very fragile and may be easily broken or avulsed during direct laryngoscopy. Laryngoscopy and tracheal intubation can be difficult because of mandibular overgrowth or microretrognathia. The presence of a small nose can make nasotracheal intubation difficult.

None, except in the presence of open-angle glaucoma.