Treacher Collins syndrome

Also known as: Mandibulofacial Dysostosis; Treacher Collins–Franceschetti syndrome

Treacher Collins syndrome is a genetic condition that affects the development of bones and other tissues in the face. The severity of the syndrome varies widely amongst affected individuals.

In this article

What are the symptoms of Treacher Collins syndrome?

Treacher Collins syndrome is characterised by a combination of the following features:

  • eyes that slant down at the outer corners
  • colobomas (notched lower eyelids)
  • micrognathia (small lower jaw)
  • cleft palate (see entry Cleft Lip and/or Palate)
  • middle ear defects – the middle ear contains three small bones that transmit sound to the inner ear
  • microtia (under-developed, malformed or missing ears)
  • under-developed or missing cheekbones and side wall/floor of the eye socket
  • small or obstructed nasal passages
  • unusual hairline, with hair growing across the cheek like a sideburn.

Most children with the syndrome usually have some degree of hearing loss and those severely affected may have respiratory problems. Eye abnormalities may lead to an increased risk of eye infection and dental abnormalities may also occur. People with Treacher Collins syndrome usually have normal intelligence.

What are the causes Treacher Collins syndrome?

Mutations in the TCOF1 gene cause the condition. This gene makes a protein called treacle, which is believed to play a role in the development of bones and other tissues in the face of a developing baby. Mutations in POLR1C and POLR1D have been identified but these are thought to account for only a small proportion of cases of Treacher Collins syndrome.

How is Treacher Collins syndrome diagnosed?

A diagnosis will usually be made on the clinical features observed. X-rays may be needed to determine the extent of facial bone abnormality. Molecular testing of the genes implicated in Treacher Collins syndrome can confirm the diagnosis.

How is Treacher Collins syndrome treated?

There is no cure for Treacher Collins syndrome, treatment is designed to alleviate the symptoms a person with the syndrome will experience. It is important that hearing loss is identified early on as it can affect learning. Children will need a full audiological (hearing) assessment and may need to wear a conductive hearing aid or have implanted hearing aids. Speech and language therapy may be needed if speech development is slowing due to hearing difficulties.

For those children that have difficulty breathing, a tracheostomy (a hole into the trachea through the front of the neck) may be necessary. Corrective surgery may be needed for a cleft palate. Reconstructive surgery may also be offered to build up the cheekbones, correct the nose or an underdeveloped jaw or reconstruct the outer ear. Overcrowded teeth or malocclusion of the bite (where teeth don’t meet each other as they should) may require dental work.

Inheritance patterns and prenatal diagnosis

Inheritance patterns
In Treacher Collins syndrome, inheritance is autosomal dominant with variable expression. A very small portion (about 1%) is inherited in an autosomal recessive manner. Over half of cases are sporadic mutations (they arise without either of the parents being affected.)

Prenatal diagnosis
Prenatal diagnosis can sometimes be performed by molecular (DNA) testing if the mutation in a family is known. For pregnancies known to be at risk of Treacher Collins syndrome, detailed ultrasound scanning may detect some of the condition’s features.

Support for people affected by Treacher Collins syndrome and their families

If your child is affected by a medical condition or disability, we can help. Call our freephone helpline on 0808 808 3555 to get information, support and advice. We also offer emotional support for parents via our Listening Ear service.

We have a range of parent guides on aspects of caring for a disabled child in our resource library. You may also find our Early Years Support useful, which contains links to parent carer workshops and help for families going through the diagnosis process.

We’ve listed a support group below. You can also meet other parents online in our closed Facebook group.

Treacher Collins Family Support Group

Tel: 07999 981200

The Treacher Collins Family Support Group are a small UK based national charity (Reg No: 1006300). They aim to support those and their families that are affected by Treacher Collins Syndrome. This can be done in a variety of ways, such as advice, information and support over the phone, email or in person.

They offer opportunities for families to get together to support each other and also to share experiences.

You can also find them on Facebook (Treacher Collins Family Support Group – UK), and get in touch with them that way and see what we have coming up.

Group details last updated February 2024.


Last reviewed October 2019 by Professor M Dixon, Professor of Dental Genetics, University of Manchester, Manchester, UK.

Although great care has been taken in the compilation and preparation of all entries to ensure accuracy, we cannot accept responsibility for any errors or omissions. Any medical information provided is for education/information purposes and is not designed to replace medical advice by a qualified medical professional.

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