A Case of a Picky Eater with Stickler’s Syndrome

Abstract

Stickler’s syndrome (STL) is an autosomal dominant connective tissue dysplasia caused by abnormality of type II collagen. It is associated with progressive ocular and ear disease, and joint problems, midface hypoplasia, cleft palate, and micrognathia. Almost all patients do not have an intellectual disorder, but they need support for eating because of many dysfunctions and disease complications. However, there are no reports on rehabilitation for eating among patients with STL.

We report the case of a girl with STL. She was 2 years and 9 months old at the first visit. The chief complaint from her mother was that she was a picky eater. She had a cleft palate, severe myopia, otitis media with effusion, vertebral epiphyseal dysplasia, growth disorders, overbite occlusion, and narrow palate. During eating, she could chew something, but she seemed to become weary after eating for a long time. The more she ate, the more slowly she chewed. She accepted rice with curry or laver boiled down in soy, and hated crispy food. When she went to the day support center at 2 years and 11 months old, she refused to eat more because of mental and physical fatigue. We instructed her mother to follow three points:first, to change food to her favorite color;second, mealtimes should be 20 minutes;third, whenever the child could eat new food, her mother must compliment her. The child had not been able to eat until 5 years and 10 months old, but she gradually began to try new foods. In this case, her picky eating was caused by sensitivity disorders such as the eyes and ears, orofacial disability with structured abnormality, and feebleness. Support should be provided to prevent eating disorders, including monitoring of temporomandibular arthritis.