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No HPO annotations are available for this condition.
Mandibulofacial dysostosis with microcephaly (MFDM) is a multiple malformation syndrome comprising craniofacial skeletal anomalies, microcephaly, developmental delay / intellectual disability, abnormalities of the ears and hearing, and, in some instances, extracranial malformations (esophageal atresia, congenital heart defects, thumb anomalies), and/or short stature. To date, 126 individuals have been identified with a pathogenic variant in EFTUD2 [, , , , , , , , , , , , , , , , , , , , , ]. The following description of the phenotypic features associated with this condition is based on these reports. Table 2. Mandibulofacial Dysostosis with Microcephaly: Frequency of Select Features
Mandibulofacial dysostosis with microcephaly (MFDM) should be suspected in individuals with mandibulofacial dysostosis (a developmental disorder of the first and second branchial arches characterized by malar and maxillary hypoplasia) in the context of one or more additional features, including:
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
No approved treatments are currently available for acrofacial dysostosis. The disease remains an area of unmet medical need.
To establish the extent of disease and needs in an individual diagnosed with mandibulofacial dysostosis with microcephaly (MFDM), the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
Table 4.
Recommended Evaluations Following Initial Diagnosis in Individuals with Mandibulofacial Dysostosis with Microcephaly
Table 6. Recommended Surveillance for Individuals with MFDM
System/Concern |
|---|
1 clinical trial registered, 1 recruiting. Interventions under study include other interventions. Research is primarily sponsored by academic and government institutions.
18 publications have been identified in PubMed for acrofacial dysostosis. Research spans Basic Science / Preclinical (56%), Review / Meta-Analysis (22%), and Case Report / Case Series (11%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 10 | 56% |
Data assembled from 5 of 12 sources · Last updated Sep 19, 2026, 12:09 AM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about acrofacial dysostosis
Feature | % of Personsw/Feature | Comment |
|---|---|---|
differences | Malar hypoplasia | 92% |
Micrognathia / Mandibularhypoplasia | 93% | — |
Cleft palate | 43% | — |
Choanal atresia | 30% | — |
Facial asymmetry | 58% | — |
Microcephaly | 87% | Occipitofrontal circumference ≥2 SD below mean |
Developmental delay / Intellectual disability | 97% | Severity varies (may be mild, moderate, or severe; critical sequelae (e.g. neonatal airway compromise, cardiac anomalies) may affect developmental outcome. Ear malformations |
hearing loss | Microtia / Dysplastic pinna(e) | 97% |
Auditory canal atresia or stenosis | 68% | — |
Preauricular tag | 50% | — |
Hearing loss | 83% | — |
Other findings | Cardiac anomalies | 35% |
Thumb anomalies | 34% | Typically proximally placed; uncommonly, preaxial polydactyly or hypoplasia |
Esophageal atresia /Tracheoesophageal fistula | 33% | — |
Short stature | 30% | — |
Spine anomalies | 28% | Incl scoliosis, kyphosis, hemivertebrae, cervical segmentation anomalies |
Epilepsy | 26% | Mandibulofacial dysostosis is characterized by malar and maxillary hypoplasia. Cleft palate in MFDM occurs as a Pierre Robin sequence, characterized by a midline bony defect without accompanying cleft lip. Submucous cleft has also been described. |
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
Mandibulofacial Dysostosis
Table 3.
Genes of Interest in the Differential Diagnosis of Mandibulofacial Dysostosis with Microcephaly
Gene(s) | DiffDx Disorder | MOI | Clinical Characteristics of DiffDx Disorder Overlapping w/MFDM | Distinguishing Features
CHD71 | CHARGE syndrome(See CHD7 Disorder.) | AD | Microcephaly, ear anomalies, choanal atresia, TEF, CHD | Ocular coloboma Mondini malformation are present in CHARGE but not in MFDM.
| Miller acrofacial dysostosis(OMIM 263750) | AR | MFD w/postaxial limb defects ± other extracranial malformations | OFC intelligence are typically normal in Miller acrofacial dysostosis.
POLR1C
POLR1D
| Treacher Collins syndrome (TCS) | ADAR | • MFD (may resemble MFD in MFDM)
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
System/Concern | Evaluation | Comment
MFD | • Airway assessment for evidence of upper-airway obstruction w/or w/o choanal atresia
Exam for midline cleft palate referral to multidisciplinary cleft palate team as required
| Important in newborns w/disorder
| Developmental assessment | Incl adaptive, cognitive, speech-language evals
| Audiologic eval | Assess for hearing loss.
| Urgent eval in newborns, esp in those w/history of polyhydramnios, unexplained respiratory distress, /or failed nasogastric tube placement |
| Echocardiogram cardiologist eval |
| Renal ultrasound |
Skeletal
anomaly | Radiograph to assess for scoliosis, rib or thumb malformation as clinically indicated |
| Assess w/growth charts. | Height growth curves for MFDM are published.1
Genetic
counseling | By genetics professionals2 | To inform affected persons families re nature, MOI, implications of MFDM to facilitate medical personal decision making
Family support
resources | Assess need for:
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
1 trial found
Frequency |
|---|
Mandibulofacial dysotosis | Evaluate for obstructive sleep apnea. | As needed Developmental delay/ |
Intellectual disability | Developmental assessment psychoeducational testing for children | Periodically throughout childhood |
Short stature | Growth parameters | Annually throughout childhood adolescence |
Epilepsy | Neurologic eval w/EEG /or brain imaging if appropriate | As needed |
Source: GeneReviews — "Mandibulofacial Dysostosis with Microcephaly"
Research summaries |
4 |
22% |
Patient case studies | 2 | 11% |
Disease patterns and progression | 2 | 11% |
Chen A (2026). [PMID: 41664038](https://pubmed.ncbi.nlm.nih.gov/41664038/). *BMC Med Genomics*. [Basic Science / Preclinical]
Van Roey V (2026). [PMID: 42095487](https://pubmed.ncbi.nlm.nih.gov/42095487/). *J Plast Surg Hand Surg*. [Review / Meta-Analysis]
Aubert Mucca M (2026). [PMID: 41339098](https://pubmed.ncbi.nlm.nih.gov/41339098/). *Clinical genetics*. [Basic Science / Preclinical]
Qin J (2026). [PMID: 41667381](https://pubmed.ncbi.nlm.nih.gov/41667381/). *WIREs mechanisms of disease*. [Epidemiology / Natural History]
van Roey VL (2025). [PMID: 40387849](https://pubmed.ncbi.nlm.nih.gov/40387849/). *The Journal of craniofacial surgery*. [Review / Meta-Analysis]
Griffin C (2025). [PMID: 40047147](https://pubmed.ncbi.nlm.nih.gov/40047147/). *Developmental dynamics : an official publication of the American Association of Anatomists*. [Basic Science / Preclinical]
Kanai Y (2025). [PMID: 39324487](https://pubmed.ncbi.nlm.nih.gov/39324487/). *American journal of medical genetics. Part A*. [Basic Science / Preclinical]
Silvey S (2025). [PMID: 41010008](https://pubmed.ncbi.nlm.nih.gov/41010008/). *Genes*. [Basic Science / Preclinical]
van Roey VL (2025). [PMID: 40694792](https://pubmed.ncbi.nlm.nih.gov/40694792/). *The Journal of craniofacial surgery*. [Epidemiology / Natural History]
Gonzalez JA (2025). [PMID: 40820387](https://pubmed.ncbi.nlm.nih.gov/40820387/). *Birth defects research*. [Basic Science / Preclinical]