DAMASCUS-(MaraviPost)-Syrian medical specialists have documented an extraordinary congenital facial abnormality in a baby girl who was only 25 days old when she was examined with a rare tube-shaped structure resembling a miniature elephant’s trunk growing beside her right eye.
According to a medical research report published in the scientific journal Acta Oto-Laryngologica Case Reports on June 21, 2025, the unusual condition was identified by specialists affiliated with Damascus University and Al-Mouwasat University Hospital in Syria, who documented the case in a study titled Proboscis lateralis: A rare case report and brief literature review.
The infant was diagnosed with a condition medically known as proboscis lateralis, an exceptionally uncommon congenital craniofacial malformation that causes an abnormal tubular appendage to develop near the inner corner of the eye, close to the nose.
The unusual growth measured approximately 2.5 centimetres in length and one centimetre in diameter, making it a particularly striking feature of the newborn’s facial development.
Medical examinations established that the abnormal structure was located near the right medial canthus, the area where the upper and lower eyelids meet closest to the nose. The appendage also released a clear, watery fluid from its outer end, while its attachment point appeared closed.
Further investigations revealed that the baby’s right nasal cavity had not developed normally, a condition medically described as nasal cavity hypoplasia. Doctors also identified a deviation of the nasal septum towards the right side, indicating that the unusual facial development involved more than the visible external growth.
A computed tomography (CT) scan provided additional information about the abnormality, revealing that the structure contained soft tissue and cartilage, together with a small fragment of bone measuring approximately 8.8 by 2.2 millimetres in its upper portion.
The imaging examination also established that the abnormal appendage had no direct connection to the nasal cavity, an important finding for understanding its anatomical structure and considering possible treatment options.
Despite the unusual facial presentation, the medical team reported several reassuring findings. An ophthalmological examination did not identify abnormalities affecting the baby’s eyes or tear drainage system, while examinations also found no evidence of cardiac, kidney, neurological or other major associated abnormalities.
The baby was born at full term without reported delivery complications, and her parents indicated that there was no family history of hereditary malformations or congenital abnormalities.
The researchers also highlighted that the parents were not related by blood, making the case particularly noteworthy because some previously documented occurrences of proboscis lateralis have been associated with consanguineous marriages.
However, doctors faced a difficult decision when considering the possibility of correcting the abnormality through surgery.
Given the technical complexity of operating on such a delicate facial structure in a baby who was barely three weeks old, specialists decided to suspend surgical intervention rather than proceed immediately.
The researchers explained that the unusual nature of the condition and the challenges associated with the surgical approach at such an early age influenced their decision.
The study also indicated that an MRI examination could not be conducted because advanced imaging was not covered by the family’s government health insurance, while the cost of paying privately was prohibitive.
Proboscis lateralis develops during early facial formation before birth, when structures that normally combine to create the nose and surrounding facial features fail to develop or fuse in the expected manner.
The resulting abnormality can produce a soft, trunk-like appendage near the inner corner of an eye, with variations in its size, location and underlying anatomical composition.
Although the external appearance is distinctive, medical specialists emphasise the importance of examining the surrounding facial structures and other organs because the condition can sometimes occur alongside additional craniofacial or neurological abnormalities.
The researchers noted that the condition is extraordinarily rare, with previously reported estimates placing its occurrence between approximately one in 100,000 and one in one million live births.
The Syrian case carries additional medical significance because the authors described it as the first documented occurrence in Syria and, to their knowledge, the wider Middle East.
By publishing their findings, the medical specialists sought to contribute to the limited international body of knowledge surrounding the condition and provide information that could assist other doctors confronting similar cases.
The report demonstrates the importance of detailed clinical examinations and advanced imaging in identifying rare congenital abnormalities, particularly where unusual external features may be accompanied by less visible anatomical changes.
Although the immediate surgical challenges prevented doctors from proceeding with corrective treatment, documenting the infant’s condition has provided valuable information for future medical assessment and research into one of the rarest abnormalities affecting facial development.
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