Goldenhar syndrome is a rare congenital defect characterized by incomplete development of the ear, nose, soft palate, lip and mandible on usually one side of the body. Common clinical manifestations include limbal dermoids, preauricular skin tags and strabismus. It is associated with anomalous development of the first branchial arch and second branchial arch.The term is sometimes used interchangeably with hemifacial microsomia, although this definition is usually reserved for cases without internal organ and vertebrae disruption. It affects between 1 in 3,500 and 1 in 5,600 live births, with a male-to-female ratio of 3:2. Signs and symptoms
Chief markers of Goldenhar syndrome are incomplete development of the ear, nose, soft palate, lip, and mandible on usually one side of the body. Additionally, some patients will have growing issues with internal organs, especially heart, kidneys and lungs. Typically, the organ will either not be present on one side or will be underdeveloped. While it is more usual for there to be problems on only one side, it has been known for defects to occur bilaterally (approximate incidence 10% of confirmed GS cases).Other problems can include severe scoliosis (twisting of the vertebrae), limbal dermoids and hearing loss (see hearing loss with craniofacial syndromes), and deafness or blindness in one or both ears/eyes. Granulosa cell tumors may be associated as well. Causes
The cause of Goldenhar syndrome is largely unknown. However, it is thought to be multifactorial, although there may be a genetic component, which would account for certain familial patterns.
Blood pressure is also higher in those with android obesity which leads to cardiovascular disease.Women who are infertile and have polycystic ovary syndrome show high amounts of android fat tissue. In contrast, patients with anorexia nervosa have increased gynoid fat percentage  Women normally have small amounts of androgen, however when the amount is too high they develop male psychological characteristics and male physical characteristics of muscle mass, structure and function and an android adipose tissue distribution. Women who have high amounts of androgen and thus an increase tendency for android fat distribution are in the lowest quintiles of levels of sex-hormone-binding globulin and more are at high risks of ill health associated with android fat High levels of android fat have been associated with obesity  and diseases caused by insulin insensitivity, such as diabetes. Insulin responsiveness is dependent on adipose cell size. The larger the adipose cell size the less sensitive the insulin. Diabetes is more likely to occur in obese women with android fat distribution and hypertrophic fat cells. It is not just general obesity that is a consequence of android fat distribution but also other health consequences. There are connections between high android fat distributions and the severity of diseases such as acute pancreatitis - where the higher the levels of android fat are, the more severe the pancreatitis can be. An increase in android fat distribution is positively correlated with foot pain and disability associated with foot pain.