Treacher Collins Syndrome: Genetics, Clinical Features and Management

Genes (Basel). 2021 Sep 9;12(9):1392. doi: 10.3390/genes12091392.


Treacher Collins syndrome (TCS) is associated with abnormal differentiation of the first and second pharyngeal arches, occurring during fetal development. Features of TCS include microtia with conductive hearing loss, slanting palpebral fissures with possibly coloboma of the lateral part of lower eyelids, midface hypoplasia, micrognathia as well as sporadically cleft palate and choanal atresia or stenosis. TCS occurs in the general population at a frequency of 1 in 50,000 live births. Four subtypes of Treacher Collins syndrome exist. TCS can be caused by pathogenic variants in the TCOF1, POLR1D, POLR1C and POLR1B genes. Genetically, the TCOF1 gene contains 27 exons which encodes the Treacle protein. In TCOF1, over 200 pathogenic variants have been identified, of which most are deletions leading to a frame-shift, that result in the formation of a termination codon. In the presented article, we review the genetics and phenotype of TCS as well as the management and surgical procedures utilized for treatment.

Keywords: TCOF1 gene; Treacher Collins syndrome; diagnosis; mandibulofacial dysostosis; phenotype; treacle protein.

Publication types

  • Review

MeSH terms

  • Choanal Atresia / etiology
  • Choanal Atresia / genetics
  • Choanal Atresia / surgery
  • DNA-Directed RNA Polymerases / genetics
  • Humans
  • Mandibulofacial Dysostosis / etiology*
  • Mandibulofacial Dysostosis / genetics
  • Mandibulofacial Dysostosis / surgery
  • Mandibulofacial Dysostosis / therapy*
  • Nuclear Proteins / genetics
  • Phosphoproteins / genetics
  • Syndrome


  • Nuclear Proteins
  • Phosphoproteins
  • TCOF1 protein, human
  • DNA-Directed RNA Polymerases
  • POLR1B protein, human
  • POLR1C protein, human
  • POLR1D protein, human