Micrognathia

Last revised by Dr Daniel J Bell on 19 Feb 2021

The term micrognathia describes a small mandible.

Micrognathia is associated with a vast array of other congenital anomalies which include:

A small mandible occurs secondary to abnormalities of the first branchial arch which in turn are caused by deficient or insufficient migration of neural crest cells and usually occur around the 4th week of gestation.

Due to a large portion of normal mandibular growth occurring in the 3rd trimester, the condition is best diagnosed towards the latter half of pregnancy

  • a true sagittal facial image would show a receding chin
  • the facial profile view is most useful in evaluating the mandibular size

Micrognathia is often a subjective finding best appreciated on a midline sagittal view.

Parameters used for objective measurement include:

If fetal swallowing is impaired there may be evidence of polyhydramnios.

Due to a high association rate with other anomalies, the detection of micrognathia warrants a careful search for other fetal abnormalities.

The overall prognosis is highly variable dependent on the presence of other associated anomalies. Even when there is isolated fetal breathing (respiratory) difficulty at the time of birth, it is a concern 5. In selected case a genioplasty may be an option in later life.

Severe micrognathia can potentially compromise neonatal respiration after birth.

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Cases and figures

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