Rare craniofacial clefts: Tessier no. 4 clefts.

Abstract:

:A major difficulty in understanding rare craniofacial clefts arises from the fact that previous reports have focused on a single case or have grouped together different types of rare clefts. Less than 50 Tessier no. 4 clefts have been reported. This paper examines our experience with eight patients treated primarily or secondarily for Tessier no. 4 clefts. A treatment plan is recommended. The primary early concern is protection of the eye. Early correction of soft-tissue deformities should include skin, muscle, and lining of the orbit, cheek, and oral cavity. Contrary to the dictum that all soft tissue must be preserved, the medial portion of the upper lip from the cleft to the philtral ridge must be resected to prevent poorly camouflaged scars, muscle deficiency, and macrostomia. Bone grafting should be undertaken at an early age using calvarial bone. Late operations will be necessary for correction of medial and lateral canthal position, epiphora, lower eyelid skin deficiency, and further bony augmentation.

journal_name

Plast Reconstr Surg

authors

Resnick JI,Kawamoto HK Jr

doi

10.1097/00006534-199006000-00001

subject

Has Abstract

pub_date

1990-06-01 00:00:00

pages

843-9; discussion 850-2

issue

6

eissn

0032-1052

issn

1529-4242

journal_volume

85

pub_type

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