Description

A patient with thalassemia intermedia or major often develops a number of changes in facial appearance. These are causes by an expansion of the facial bones due to the erythroid hyperplasia that occurs as a result of the disease.


 

Synonym: facies Cooley (from Asbell)

 

Onset: in childhood

 

Facial features:

(1) significant maxillary enlargement with high and prominent cheek bones

(2) mandibular enlargement that is less than the maxillary enlargement, resulting in disproportion between the 2 dental arches

(3) dental malocclusion with open bite, cross bite and/or overbite

(4) relatively narrow face

(5) retraction of the upper lip

 

Other findings

(1) pallor to the oral mucosa

(2) gingivitis and dental caries if there poor dental hygiene

 


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