Mixed Nuts

He was delayed in sitting until the age of 2, delayed in walking at the age of 4, he only has partial hearing, he had surgery for his hernia, he has gnathopalatoschisis (splitting of his jaw and palate), hypoplasia of right kidney, his mouth is slightly wry (wried) towards the deformed ear, he has subcompensated hydrocephaly although his head is of right shape and size. He cannot really talk because he has hearing loss. He continues to experience malnutrition due to his mouth abnormalities and institutional care. He has absence of earflap, sub-compensated hydrocephaly, Goldenhar’s syndrome (no ear), closed acoustic duct, mixed hearing loss, cleft palate, crossed actopic kidney and developmental delays as well as cosmetic facial differences.


This child is likely to have the following problems - hearing problems, weakness in moving the side of the face that is smaller, dental problems - the soft palate may move to the unaffected side of the face, the tongue may be smaller on the affected side of the face, fusion of the bones of the neck.

Depending on the severity of Goldenhar Syndrome, the child may have some or all of the following surgeries - lowering of the jaw on the affected side, lengthening of the lower jaw, 3 to 4 operations to rebuild the outer ear, addition of bone to build up the cheeks, soft tissue may need to be added to the face. Other possible diagnosis could be Oculoauicular Dysplasia or OAV or Hemifacial Microsomia.