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The Rare Facial Cleft

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Cleft Lip and Palate Treatment

Abstract

Rare facial cleft has a broad spectrum of clinical presentation as soft tissue and bony structures can be malformed, clefting or absent. The face is a complete three-dimensional structure, composed by regions with different topography, skin thickness, texture, and color. In patients with rare facial cleft, hair follicles may accompany the cleft, especially those above the orbit or that are completely absent causing alopecia, absence of eyebrow and eyelash.

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References

  • Abdollahifakhim S, Shahidi N, Bayazian G. A bilateral tessier number 4 and 5 facial cleft and surgical strategy: a case report. Iran J Otorhinolaryngol. 2013;25(73):259–62.

    PubMed Central  PubMed  Google Scholar 

  • Agrawal K, Panda KN, Prasad S. Isolated Tessier no. 1 cleft of the nose. Ann Plast Surg. 1998;41(3):311–3.

    Article  CAS  PubMed  Google Scholar 

  • Akoz T, Erdogan B, Gorgu M, Kutlay R, Dag F. Bilaterally involved Tessier no. 4 cleft: case report. Cleft Palate Craniofac J. 1996;33(3):252–4.

    Article  CAS  PubMed  Google Scholar 

  • Allam KA, Wan DC, Kawamoto HK, Bradley JP, Sedano HO, Saied S. The spectrum of median craniofacial dysplasia. Plast Reconstr Surg. 2011 Feb;127(2):812–21.

    Article  CAS  PubMed  Google Scholar 

  • Allam KA, Lim AA, Elsherbiny A, Kawamoto HK. The Tessier number 3 cleft: a report of 10 cases and review of literature. J Plast Reconstr Aesthet Surg. 2014;67(8):1055–62.

    Article  PubMed  Google Scholar 

  • Alonso N, Freitas RS, de Oliveira e Cruz GA, Goldenberg D, DallOglio Tolazzi AR. Plast Reconstr Surg. 2008;122(5):1505–13.

    Google Scholar 

  • Bhattacharyya NC, Kalita K, Gogoi M, Deuri PK. Tessier 30 facial cleft. J Indian Assoc Pediatr Surg. 2012;17(2):75–7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bodin F, Salazard B, Bardot J, Magalon G. Craniofacial cleft: a case of Tessier no. 3, 7 and 11 cleft. J Plast Reconstr Aesthet Surg. 2006;59(12):1388–90.

    Article  CAS  PubMed  Google Scholar 

  • Boo-Chai K. The transverse facial cleft: its repair. Br J Plast Surg. 1969;22:119–24.

    Google Scholar 

  • Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension. Plast Reconstr Surg. 1986;78(2):145–57.

    Article  CAS  PubMed  Google Scholar 

  • David DJ, Moore MH, Cooter RD, Chow SK. The Tessier number 9 cleft. Plast Reconstr Surg. 1989;83(3):520–7.

    Article  CAS  PubMed  Google Scholar 

  • Denadai R, Raposo-Amaral CA, Pinho AS, et al. Predictors of autologous free fat graft retention in the management of craniofacial contour deformities. Plast Reconstr Surg. 2017;140:50e–61e.

    Google Scholar 

  • Denadai R, Raposo-Amaral CA, Buzzo CL, et al. Isolated autologous free fat grafting for management of facial contour asymmetry in a subset of growing patients with craniofacial microsomia. Ann Plast Surg. 2016;76:288–94.

    Google Scholar 

  • Dumortier R, Delhemmes P, Pellerin P. Bilateral Tessier no. 9 cleft. J Craniofac Surg. 1999;10(6):523–5.

    Article  CAS  PubMed  Google Scholar 

  • Dunaway DJ, Britto JA, Abela C, Evans RD, Jeelani NU. Complications of frontofacial advancement. Childs Nerv Syst. 2012;28(9):1571–6.

    Article  PubMed  Google Scholar 

  • Fuente-del-Campo A. Surgical correction of Tessier number 8 cleft. Plast Reconstr Surg. 1990;86(4):658–61. discussion 62-3

    Article  CAS  PubMed  Google Scholar 

  • Galante G, Dado DV. The Tessier number 5 cleft: a report of two cases and a review of the literature. Plast Reconstr Surg. 1991;88(1):131–5.

    Article  CAS  PubMed  Google Scholar 

  • Garg A, Goyal S. Tessier number 5 cleft. Indian Pediatr. 2009;46(10):907.

    PubMed  Google Scholar 

  • Gargano F, Szymanski K, Bosman M, Podda S. Tessier 1-13 atypical craniofacial cleft. Eplasty. 2015;15:ic32.

    PubMed Central  PubMed  Google Scholar 

  • Gawrych E, Janiszewska-Olszowska J, Chojnacka H. Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate. Int J Oral Maxillofac Surg. 2010;39(11):1133–6.

    Article  CAS  PubMed  Google Scholar 

  • Gonzalez-Ulloa M. Restoration of the face covering by means of selected skin in regional aesthetic units. Br J Plast Surg. 1956;9(3):212–21.

    Article  CAS  PubMed  Google Scholar 

  • Gonzalez-Ulloa M. Selective regional restoration by means of esthetic units. Prensa Med Mex. 1958;23(2):68–73.

    CAS  PubMed  Google Scholar 

  • Horgan JE, Padwa BL, LaBrie RA, Mulliken JB. OMENS-plus: analysis of craniofacial and extracraniofacial anomalies in hemifacial microsomia. Cleft Palate Craniofac J. 1995;32(5):405–12.

    Article  CAS  PubMed  Google Scholar 

  • Karfik V. [Proposed classification of rare congenital cleft defects of the face]. Rozhl Chir. 1966;45:518–22.

    Google Scholar 

  • Kale SM, Pakhmode VK. Bilateral Tessier no. 4 facial cleft with left eye anophthalmos: a case report. J Indian Soc Pedod Prev Dent. 2000;18(3):87–9.

    CAS  PubMed  Google Scholar 

  • Kawamoto HK Jr. The kaleidoscopic world of rare craniofacial clefts: order out of chaos (Tessier classification). Clin Plast Surg. 1976;3(4):529–72.

    PubMed  Google Scholar 

  • Kececi Y, Gencosmanoglu R, Gorken C, Cagdas A. Facial cleft no. 30. J Craniofac Surg. 1994;5(4):263–4.

    Article  CAS  PubMed  Google Scholar 

  • Laure B, Picard A, Bonin-Goga B, Letouze A, Petraud A, Goga D. Tessier number 4 bilateral orbito-facial cleft: a 26-year follow-up. J Craniomaxillofac Surg. 2010;38(4):245–7.

    Article  PubMed  Google Scholar 

  • Lee HM, Noh TK, Yoo HW, Kim SB, Won CH, Chang SE, et al. A wedge-shaped anterior hairline extension associated with a tessier number 10 cleft. Ann Dermatol. 2012;24(4):464–7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ligh CA, Swanson J, Yu J, Samra F, Bartlett SP, Taylor JA. A morphological classification scheme for the mandibular hypoplasia in Treacher Collins syndrome. Plast Reconstr Surg. 2015;136(4 Suppl):46.

    Article  PubMed  Google Scholar 

  • Morioka D, Simic R, Vlahovic A, Kravljanac D. Tessier 30 median mandibular cleft associated with lower lip hemangioma. Plast Reconstr Surg. 2003;112(3):935.

    Article  PubMed  Google Scholar 

  • Nam SM, Kim YB. The Tessier number 14 facial cleft: a 20 years follow-up. J Craniomaxillofac Surg. 2014;42(7):1397–401.

    Article  PubMed  Google Scholar 

  • Nguyen PD, Caro MC, Smith DM, Tompson B, Forrest CR, Phillips JH. Long-term orthognathic surgical outcomes in Treacher Collins patients. J Plast Reconstr Aesthet Surg. 2016;69(3):402–8.

    Article  CAS  PubMed  Google Scholar 

  • Ozek C, Gundogan H, Bilkay U, Cankayali R, Guner U, Gurler T, et al. Rare craniofacial anomaly: Tessier no. 2 cleft. J Craniofac Surg. 2001;12(4):355–61.

    Article  CAS  PubMed  Google Scholar 

  • Pidgeon TE, Flapper WJ, David DJ, Anderson PJ. From birth to maturity: midline tessier 0-14 craniofacial cleft patients who have completed protocol management at a single craniofacial unit. Cleft Palate Craniofac J. 2014;51(4):e70–9.

    Article  PubMed  Google Scholar 

  • Pittet B, Jaquinet A, Rilliet B, Montandon D. Simultaneous correction of major hypertelorism, frontal bone defect, nasal aplasia, and cleft of the upper lip (Tessier 0-14). Plast Reconstr Surg. 2004;113(1):299–303.

    Article  PubMed  Google Scholar 

  • Plomp RG, van Lieshout MJ, Joosten KF, Wolvius EB, van der Schroeff MP, Versnel SL, et al. Treacher Collins syndrome: a systematic review of evidence-based treatment and recommendations. Plast Reconstr Surg. 2016;137(1):191–204.

    Article  CAS  PubMed  Google Scholar 

  • Poon CC, Meara JG, Heggie AA. Hemifacial microsomia: use of the OMENS-plus classification at the Royal Children's Hospital of Melbourne. Plast Reconstr Surg. 2003;111(3):1011–8.

    Article  PubMed  Google Scholar 

  • Portier-Marret N, Hohlfeld J, Hamedani M, de Buys Roessingh AS. Complete bilateral facial cleft (Tessier 4) with corneal staphyloma: a rare association. J Pediatr Surg. 2008;43(10):e15–8.

    Article  PubMed  Google Scholar 

  • Presti F, Celentano C, Marcazzo L, Dolcetta G, Prefumo F. Ultrasound prenatal diagnosis of a lateral facial cleft (Tessier number 7). Ultrasound Obstet Gynecol. 2004;23(6):606–8.

    Article  CAS  PubMed  Google Scholar 

  • Raposo-Amaral CE, Raposo-Amaral CM, Raposo-Amaral CA, Chahal H, Bradley JP, Jarrahy R. Age at surgery significantly impacts the amount of orbital relapse following hypertelorbitism correction: a 30-year longitudinal study. Plast Reconstr Surg. 2011;127(4):1620–30.

    Google Scholar 

  • Raposo-Amaral CE, Denadai R, Camargo DN, et al. Parry-Romberg syndrome: severity of the deformity does not correlate with quality of life. Aesthetic Plast Surg. 2013;37:792–801.

    Google Scholar 

  • Raposo-Amaral CE, Denadai R, Ghizoni E, et al. Surgical strategies for soft tissue management in hypertelorbitism. Ann Plast Surg. 2017;78:421–27.

    Google Scholar 

  • da Silva FR, Alonso N, Shin JH, Busato L, Ono MC, Cruz GA. Surgical correction of Tessier number 0 cleft. J Craniofac Surg. 2008;19(5):1348–52.

    Article  Google Scholar 

  • da Silva FR, Alonso N, Shin JH, Busato L, DallOglio Tolazzi AR, de Oliveira e Cruz GA. The Tessier number 5 facial cleft: surgical strategies and outcomes in six patients. Cleft Palate Craniofac J. 2009;46(2):179–86.

    Google Scholar 

  • da Silva FR, Alonso N, Busato L, Ueda WK, Hota T, Medeiros GH, Kunz RT. Oral-nasal-ocular cleft: the greatest challeng among the rare clefts. J Craniofac Surg. 2010;21(2):390–5.

    Google Scholar 

  • Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg. 1976;4(2):69–92.

    Article  CAS  PubMed  Google Scholar 

  • Tiwari P, Bhatnagar SK, Kalra GS. Tessier number 2 cleft, a variation. Case report. J Craniomaxillofac Surg. 1991;19(8):346–7.

    Article  CAS  PubMed  Google Scholar 

  • Tokioka K, Nakatsuka T, Park S, Okouchi M, Aiba E. Two cases of Tessier no. 4 cleft with anophthalmia. Cleft Palate Craniofac J. 2005;42(4):448–52.

    Article  PubMed  Google Scholar 

  • Wenbin Z, Hanjiang W, Xiaoli C, Zhonglin L. Tessier 3 cleft with clinical anophthalmia: two case reports and a review of the literature. Cleft Palate Craniofac J. 2007;44(1):102–5.

    Article  PubMed  Google Scholar 

  • Woods RH, Varma S, David DJ. Tessier no. 7 cleft: a new subclassification and management protocol. Plast Reconstr Surg. 2008;122(3):898–905.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors thank the plastic surgeon and artist Jorge Vitale for the drawings given to Prof. Dr. Cassio Raposo do Amaral.

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Correspondence to Cassio Eduardo Raposo-Amaral M.D., Ph.D. .

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Raposo-Amaral, C.E., Jarrahy, R., Lim, R., Alonso, N. (2018). The Rare Facial Cleft. In: Alonso, N., Raposo-Amaral, C. (eds) Cleft Lip and Palate Treatment. Springer, Cham. https://doi.org/10.1007/978-3-319-63290-2_21

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  • DOI: https://doi.org/10.1007/978-3-319-63290-2_21

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