To the Editor .—Dudding et al 1 in 1967 reported a family with multiple defects and suggested it be called the oto-palato-digital syndrome. In the sibship described there were three affected male subjects. It was suggested that the entity was probably autosomal recessive but could be X-linked. Two boys have recently been seen at this clinic with similar anomalies; they are half brothers. The clinical details and roentgenograms were sent to the National Foundation Birth Defects Evaluation Center, Boston, who diagnosed the otopalato-digital syndrome. Their clinical features are identical with those described. The mother of these two boys is