Congenital fusion of the maxilla and mandible (syngnathia) is rare and can
present in a wide range of severity from single mucosal bands (synechiae) t
o complete bony fusion (synostosis). Congenital synostosis of the mandible
and maxilla is even less common than synechiae, with only 19 cases reported
in the literature. Most of them have presented as an incomplete, unilatera
l fusion. Only three of the reported cases showed more extensive but still
incomplete, intermaxillary bony fusion. We present a case of complete bony
fusion of the maxilla and mandible associated with a cleft palate, hypoglos
sia, micrognathia, unilateral choanal atresia, and limb abnormalities as a
feature of oromandibular limb hypogenesis syndrome. Details of operative ma
nagement are presented.