Oral-Nasal-Ocular Cleft

Freitas, Renato da Silva; Alonso, Nivaldo; Busato, Luciano; Ueda, Wellington Keity; Hota, Thiago; Medeiros, Simone Helena; Kunz, Regiane Tiemi

doi:10.1097/scs.0b013e3181cfa6b1

Cited by 25 publications

(9 citation statements)

References 15 publications

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“…Various groups have published their treatment philosophy and approach to atypical facial clefts. [2][3][4][5][6][7][8][9] Monasterio and Taylor presented a large series of 495 major craniofacial clefts, in which they applied their revised treatment philosophy to 280 of these patients. 2 By the generous use of tissue expanders, placement of scars within anatomic boundaries, and symmetrically reconstructing facial landmarks with tissue of like color and texture, the authors have been able to reduce their incidence of facial asymmetry and visible scars post repair.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9] Surgical treatment with direct closure, local rotation flaps, use of tissue expansion, and Z-plasties have been proposed to manage these defects. [2][3][4][5][6][7][8][9] Although many craniofacial units have used these principles of treatment with reported success, a clear surgical plan and concise description of their operative technique is lacking. This is in contrast to the literature on cleft lip repair, where the operative plan has been well documented.…”

Section: Introductionmentioning

confidence: 99%

“…2–9 Surgical treatment with direct closure, local rotation flaps, use of tissue expansion, and Z-plasties have been proposed to manage these defects. 2–9 Although many craniofacial units have used these principles of treatment with reported success, a clear surgical plan and concise description of their operative technique is lacking. This is in contrast to the literature on cleft lip repair, where the operative plan has been well documented.…”

Section: Introductionmentioning

confidence: 99%

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The Anatomical Subunit Approach to Managing Tessier Numbers 3 and 4 Craniofacial Clefts

Slyke

Burge

Bos

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Patients with atypical facial clefts are rare, and there is a paucity of literature outlining the surgical approach to managing these patients. The anatomical subunit approach to the surgical correction of the cleft lip has revolutionized cleft care. Here, we outline our approach and operative technique to treating Tessier clefts 3 and 4 using a novel technique based on the anatomical subunit approach. Methods: All cases of Tessier facial clefts 3 and 4 between 2019 and 2021 from the senior author’s practice were reviewed retrospectively. Patient demographics, clinical presentation, procedure details, and complications are reported. The senior author’s technique is described in detail. Results: Five patients underwent treatment by the senior author during the study period. One patient had bilateral Tessier 4 clefts, one patient had bilateral Tessier 3 clefts, two patients had a unilateral Tessier 4 cleft, and one patient had a unilateral Tessier 3 cleft. Two of the patients had their clefts treated as secondary procedures. The surgical complication profile was a lost nasal stent in one patient. Treatment principles of the senior author’s technique are presented. Conclusions: The anatomical subunit approach to managing atypical facial clefts provides a structured approach to a complex problem for the cleft and craniofacial surgeon. The technique of repair presented here can assist surgeons attempting to treat patients with Tessier 3 and 4 clefts.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Anatomical Subunit Approach to Managing Tessier Numbers 3 and 4 Craniofacial Clefts

Slyke

Burge

Bos

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…The numbers 3 and 4 clefts as described by Tessier are rare craniofacial malformations whose clinical presentations are extensive (Alonso and Freitas, 2008). The number 3 cleft (FC 3) was described as being a paranasal-medial orbitomaxillary cleft that runs up to the eyelid in the region of the lacrimal groove (da Silva Freitas et al, 2010). The defect can affect the entire frontal process of the maxilla as well as the medial wall of the maxillary sinus.…”

Section: Introductionmentioning

confidence: 99%

“…It finally crosses to the lip and the alveolus by passing round the nasal ala in the nasolabial groove (Tessier, 1976). This cleft comes with varying manifestations from being a complete soft tissue and bony cleft affecting both the face and cranium or minorly expressed as a coloboma in the lower eyelid or a simple notch of the ala base (da Silva Freitas et al, 2010). In the FC 3, there is a deficiency or absence of the ala.…”

Section: Introductionmentioning

confidence: 99%

Tessier Number 3 and 4 Clefts: Clinical Presentation and Associated Clefts in a South African Population

Omodan

Pillay

Lazarus

et al. 2021

The Cleft Palate Craniofacial Journal

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Introduction The defects found in Tessier clefts number 3 and number 4 come in various forms in different patients. These variations have to a great extent affected not only documentation of these craniofacial defects but invariably their treatment and communication amongst craniofacial researchers. This study has not only documented the clinical presentation of these clefts in a South African population but has also incorporated the clinical presentation of Tessier clefts number 3 and 4 from different regions of the world. Methods The records of 8 patients, who had been treated for either Tessier clefts number 3 or 4, were reviewed and compared with 16 studies pulled from the literature systematically. The defects recorded as well as associated clefts and other congenital malformations were documented, and findings were compared. Results The anatomical and clinical presentation of the patients was compared to the reviewed literature and the different parameters were documented. In addition, associated clefts were also recorded in the study—it was noted that the association pattern recorded in Tessier cleft number 4 in this study did not conform to its traditional counterpart. Conclusion This study concluded that the clinical presentations of these clefts, however variable, seem to have a similar presentation worldwide. Additionally, associated clefts do not conform to the original Tessier classification system and therefore it is imperative for these patterns to be clearly mapped out.

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Oblique Facial Cleft Syndrome

Chen¹

2015

Atlas of Genetic Diagnosis and Counseling

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Oral-Nasal-Ocular Cleft

Abstract: Tessier number 3 cleft is one of the most difficult and challenging malformations to correct for the reconstructive surgeon. Besides the difficulties of its treatment, patients with Tessier number 3 cleft may achieve good results when the team has good skills.

Cited by 25 publications

References 15 publications

The Anatomical Subunit Approach to Managing Tessier Numbers 3 and 4 Craniofacial Clefts

The Anatomical Subunit Approach to Managing Tessier Numbers 3 and 4 Craniofacial Clefts

Tessier Number 3 and 4 Clefts: Clinical Presentation and Associated Clefts in a South African Population

Oblique Facial Cleft Syndrome

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