Treacher-Collins syndrome, a first-arch congenital defect, causes severe facial deformity.1The syndrome is caused by a fetal vascular anomaly depriving the first visceral arch of its blood supply, mainly from the stapedial artery, between the third and fifth weeks of gestation.2First-arch syndromes may occur in varying severity, some so slight as to he unnoticed. The disease was first described by Treacher-Collins3in 1900 and later described by Francesehetti and Klein.4It is characterized by antimongoloid obliquity of the palpebral fissure; notched lower eyelids; coloboma; mtcrophthalmia; hypoplasia of malar and mandibular bones; large mouth with irregular teeth and inalocclusion; deformed external, and sometimes middle and inner, ears. Associated with these characteristics may be deafness; preauricular blind fistula; dwarfism; cardiac defects; and occasional skeletal defects.5