Facies comparison of similar facies of Proband 3 (a) and Proband 4 (b). Proband 3 (a) with an enlarged head with microphthalmia and hypotelorism. The columella is absent, resulting in a fused single nostril although the nasal septum is present internally. The philtrum is long with a wedge-shaped depression below the fused nostril, and there is micrognathia. Comparison of hands of Proband 3 (C) and Proband 4 (D). Proband 4 (D) with hypoplastic, poorly demarcated middle phalanges on digits 2–5, with short, thick fingers.