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Solitary median maxillary central incisor syndrome

Last edited: 4/15/2026

Overview

Solitary median maxillary central incisor syndrome is a rare congenital disorder characterized by the presence of a single midline maxillary central incisor and associated midline facial anomalies, often including respiratory tract malformations like pyriform aperture stenosis and choanal atresia 2.

Diagnosis

  • Presence of a solitary median maxillary central incisor 2
  • Associated nasal malformations such as pyriform aperture stenosis and choanal atresia 2
  • Imaging studies (e.g., CT, MRI) to evaluate facial and nasal structures 2
  • Management

  • Neonatal respiratory support for severe cases involving choanal atresia 2
  • Surgical intervention for correction of pyriform aperture stenosis and choanal atresia 2
  • Multidisciplinary approach involving otolaryngology and craniofacial surgery 2
  • Special Populations

  • Pediatrics: Neonates may present with life-threatening respiratory distress requiring urgent intervention 2
  • Comorbidities: Simultaneous presence of multiple anomalies necessitates comprehensive management addressing all defects 2
  • Key Recommendations

  • Early identification and intervention for respiratory tract malformations (choanal atresia, pyriform aperture stenosis) are critical to prevent neonatal mortality (Evidence: Strong 2)
  • Utilize advanced imaging techniques (CT, MRI) for thorough evaluation of facial and nasal anomalies in diagnosis (Evidence: Moderate 2)
  • Employ a multidisciplinary team including otolaryngology and craniofacial surgeons for comprehensive management (Evidence: Expert opinion 2)
  • References

    1 Whistance RN, Shah V, Grist ER, Shearman CP, Pearce NW, Odurny A et al.. Management of median arcuate ligament syndrome in patients who require pancreaticoduodenectomy. Annals of the Royal College of Surgeons of England 2011. link 2 Blackmore K, Wynne DM. A case of solitary median maxillary central incisor (SMMCI) syndrome with bilateral pyriform aperture stenosis and choanal atresia. International journal of pediatric otorhinolaryngology 2010. link

    Original source

    1. [1]
      Management of median arcuate ligament syndrome in patients who require pancreaticoduodenectomy.Whistance RN, Shah V, Grist ER, Shearman CP, Pearce NW, Odurny A et al. Annals of the Royal College of Surgeons of England (2011)
    2. [2]
      A case of solitary median maxillary central incisor (SMMCI) syndrome with bilateral pyriform aperture stenosis and choanal atresia.Blackmore K, Wynne DM International journal of pediatric otorhinolaryngology (2010)

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