Diagnostic criteria for CHARGE syndrome

Diagnostic CharacteristicsManifestations
Major criteria
    Ocular colobomaColoboma of the iris, retina, choroid, disc; microphthalmos
    Choanal atresia or stenosisUnilateral or bilateral, bony or membranous, atresia or stenosis
    Cranial nerve dysfunction or anomalyI, Hyposmia or anosmia
VII, Facial palsy (unilateral or bilateral)
VIII, Hypoplasia of auditory nerve
IX/X, Swallowing problems with aspiration
    CHARGE syndrome earOuter ear: short, wide ear with little or no lobe, “snipped off” helix, prominent antihelix that is often discontinuous with tragus, triangular concha, decreased cartilage; often protruding and usually asymmetric
Middle ear: ossicular malformations
Cochlea: incomplete partition
Vestibular apparatus: absent or hypoplastic semicircular canals
Minor criteria
    Genital hypoplasiaMales: micropenis, cryptorchidism
Females: hypoplastic labia
    Developmental delayDelayed milestones, hypotonia
    Cardiovascular malformationConotruncal defects (eg, tetralogy of Fallot), atrioventricular canal defects, aortic arch anomalies
    Growth deficiencyShort stature, usually postnatal with or without growth hormone deficiency
    Orofacial cleftCleft lip and/or palate
    Tracheoesophageal fistulaTracheoesophageal defects of all types
    Distinctive facial featuresSquare face with broad prominent forehead, prominent nasal bridge and columella, flat midface