Tessier No. 3 and No. 4 clefts: Sequential treatment in infancy by pre-surgical orthopedic skeletal contraction, comprehensive reconstruction, and novel surgical lengthening of the ala base-canthal distance. Issue 7 (September 2015)

• Record Type: Journal Article
• Authors: Spolyar, John L.; Hnatiuk, Mark; Shaheen, Kenneth W.; Mertz, Jennifer K.; Handler, Lawrence F.; Jarial, Ravinder; Camilo Roldán, J.
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 43:Issue 7(2015:Oct.)
• Page Start: 1261
• Page End: 1268
• Publication Date: 2015-09
• Subjects: Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2015.06.002
• Languages: English
• ISSNs: 1010-5182

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Repair of facial clefts implies wide tissue mobilization with multi-stage surgical treatment. Authors propose pre-surgical orthopedic correction for naso-oro-ocular clefts and a novel surgical option for Tessier No. 3 cleft.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Two male infants, a Tessier No. 3 cleft (age 7 months) and another Tessier No. 4 (age 3months), were treated with a modified orthopedic Latham device with additional septo-premaxillary molding and observed to age four years. Tessier No. 3 orthopedic measurements were obtained by image corrected cephalometric analysis. Subsequent repair included tissue expansion on Tessier No. 4 and naso-frontal Rieger flap combined with myocutaneous upper lid flap on Tessier No. 3.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Orthopedic movements ranged from 18.5 mm in bi-planar to 33 mm in oblique analyses. Tissue margins became aligned with platform normalization. Tissue expansion on Tessier No. 4 improved distances from ala base-lower lid and subalar base-lip. The naso-frontal flap combined with myocutaneous upper lid flap on Tessier No. 3 had similar achievement, but also sufficiently lengthened ala base-canthal distance.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Repairs were facilitated by pre-surgical orthopedic correction. The naso-frontal flap combined with an upper lid myocutaneous flap seems viable as a single-stage option to lengthen ala base-canthal distance to advance repair achievement in unilateral Tessier No. 3.</p> </sec> </abstract>