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


To read more or access our algorithms and calculators, please log in or register.