Advertisement

Surgical and Radiologic Anatomy

, Volume 41, Issue 5, pp 569–574 | Cite as

Complete bilateral Tessier’s facial cleft number 5: surgical strategy for a rare case report

  • Aurélien BinetEmail author
  • A. de Buys Roessingh
  • M. Hamedani
  • O. El Ezzi
Original Article
  • 86 Downloads

Abstract

The oro-ocular cleft number 5 according to the Tessier classification is one of the rarest facial clefts and few cases have been reported in the literature. Although the detailed structure of rare craniofacial clefts is well established, the cause of these pathological conditions is not. There are no existing guidelines for the management of this particular kind of cleft. We describe the case of a 19-month-old girl with a complete bilateral facial cleft. We describe the surgical steps taken to achieve the primary correction of the soft tissue deformation. Embryologic development and radiological approach are discussed, as are also the psychological and social aspects of severe facial deformities.

Keywords

Orofacial cleft 5 Cleft palate Oblique facial cleft Craniofacial abnormalities 

Notes

Acknowledgements

The authors are grateful to Annette Wagnière for reviewing the English text.

Author contributions

AB, OEE, AdBR. data management, data analysis, manuscript writing, AB, OEE. data analysis, manuscript writing, OEE, MH. data management, data analysis, AdBR, OEE. project development, data collection.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

References

  1. 1.
    Afifi AM, Djohan R et al (2011) Long-term follow-up of a Tessier number 5 facial cleft. Craniomaxillofac Trauma Reconstr 4(1):35–42Google Scholar
  2. 2.
    Boo-Chai K (1970) The oblique facial cleft: a report of 2 cases and a review of 41 cases. Br J Plast Surg 23:352–359Google Scholar
  3. 3.
    Chancholle A, Saboye J et al (2002) Prise en charge des fentes labio-palatines par lˈéquipe du docteur Chancholle à Toulouse. Ann Chir Plast Esthet 47(2):92–105 (Elsevier)Google Scholar
  4. 4.
    Chaudré F, Garabédian E (2003) Chirurgie des fentes labio-vélo-palatines. Encycl Méd Chir 46:1–12Google Scholar
  5. 5.
    Chiong AT, Guevarra ES et al (1981) Oblique facial cleft. Arch Otolaryngol 107(1):59–62Google Scholar
  6. 6.
    Converse JM, Wood-Smith D et al (1974) Bilateral facial microsomia. Diagnosis, classification, treatment. Plast Reconstr Surg 54(4):413–423Google Scholar
  7. 7.
    Coruh A, Gunay GK (2005) A surgical conundrum: Tessier number 4 cleft. Cleft Palate Craniofac J 42(1):102–106Google Scholar
  8. 8.
    da Silva Freitas R, Alonso N et al (2009) The Tessier number 5 facial cleft: surgical strategies and outcomes in six patients. Cleft Palate Craniofac J 46(2):179–186Google Scholar
  9. 9.
    David DJ, Moore MH et al (1989) Tessier clefts revisited with a third dimension. Cleft Palate J 26(3):163–184 (discussion 184–165)Google Scholar
  10. 10.
    Eppley BL, van Aalst JA et al (2005) The spectrum of orofacial clefting. Plast Reconstr Surg 115(7):101e–114eGoogle Scholar
  11. 11.
    Galante G, Dado DV (1991) The Tessier number 5 cleft: a report of two cases and a review of the literature. Plast Reconstr Surg 88(1):131–135Google Scholar
  12. 12.
    Kawamoto H, Patel P-K (1998) Atypical facial clefts. Pediatr Plast Surg Stamford Appleton Lange, 175–225Google Scholar
  13. 13.
    Kawamoto HK Jr (1976) The kaleidoscopic world of rare craniofacial clefts: order out of chaos (Tessier classification). Clin Plast Surg 3(4):529–572Google Scholar
  14. 14.
    Martinot-Duquennoy V, Capon N (2002) Synthese de la prise en charge des fentes labiales et palatinespar onze equipes francophones en 2001. Ann Chir Plast Esthet 47(2):166–171 (Elsevier)Google Scholar
  15. 15.
    Mayou BJ, Fenton OM (1981) Oblique facial clefts caused by amniotic bands. Plast Reconstr Surg 68(5):675–681Google Scholar
  16. 16.
    Menard RM, Moore MH et al (1999) Tissue expansion in the reconstruction of Tessier craniofacial clefts: a series of 17 patients. Plast Reconstr Surg 103(3):779–786Google Scholar
  17. 17.
    Montoya P, Bigorre M et al (2002) Prise en charge des fentes labio-maxillo-palatines au centre hospitalier universitaire de Montpellier. Ann Chir Plast Esthet 47(2):143–149 (Elsevier)Google Scholar
  18. 18.
    Moore MH (1996) Rare craniofacial clefts. J Craniofac Surg 7(6):408–411Google Scholar
  19. 19.
    Morian DR (1887) Über die schräge Gesichtsspalte. Arch Klein Chir 35:245–253Google Scholar
  20. 20.
    Mustardé J (1980) The eye socket. Repair and reconstruction in the orbital region, a practical guide, 215, 2nd edn. Churchill Livingstone, LondonGoogle Scholar
  21. 21.
    Oostrom CA, Vermeij-Keers C et al (1996) Median cleft of the lower lip and mandible: case reports, a new embryologic hypothesis, and subdivision. Plast Reconstr Surg 97(2):313–320Google Scholar
  22. 22.
    Pellerin P, Martinot V et al (2002) Prise en charge des fentes labio-maxillo-palatines au sein du service de chirurgie plastique du centre hospitalier universitaire de Lille. Ann Chir Plast Esthet 47(2):106–115 (Elsevier)Google Scholar
  23. 23.
    Pitanguy I, Franco T (1967) Nonoperated facial fissures in adults. Plast Reconstr Surg 39(6):569–577Google Scholar
  24. 24.
    Portier-Marret N, Hohlfeld J et al (2008) Complete bilateral facial cleft (Tessier 4) with corneal staphyloma: a rare association. J Pediatr Surg 43(10):e15–e18Google Scholar
  25. 25.
    Rohrich RJ, Gosman AA (2004) An update on the timing of hard palate closure: a critical long-term analysis. Plast Reconstr Surg 113(1):350–352Google Scholar
  26. 26.
    Rougier J (ed) (1977) Chirurgie plastique orbito-palpébrale (vol. 45). MassonGoogle Scholar
  27. 27.
    Sano S, Tani T et al (1983) Bilateral oblique facial cleft. Ann Plast Surg 11(5):434–437Google Scholar
  28. 28.
    Stretch JR, Poole MD (1990) Nasolacrimal abnormalities in oblique facial clefts. Br J Plast Surg 43(4):463–467Google Scholar
  29. 29.
    Talmant J, Lumineau J et al (2002) Prise en charge des fentes labio-maxillo-palatines par l’équipe du docteur Talmant à Nantes. Ann Chir Plast Esthet, Elsevier 47(2):116–125Google Scholar
  30. 30.
    Tessier P (1976) Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 4(2):69–92Google Scholar
  31. 31.
    Tessier P (1976) Anatomical classification of facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 4:69–92Google Scholar
  32. 32.
    Thorne C (1993) Craniofacial clefts. Clin Plast Surg 20(4):803–814Google Scholar
  33. 33.
    Trier WC, Dreyer TM (1984) Primary von Langenbeck palatoplasty with levator reconstruction: rationale and technique. Cleft Palate J 21(4):254–262Google Scholar
  34. 34.
    Uchikawa Y, Ogata H et al (2011) Palatoplasty for bilateral oblique cleft of the soft palate accompanied by Tessier number 5.7 cleft. Cleft Palate Craniofac J 48(2):231–235Google Scholar
  35. 35.
    Van der Meulen J (1988) Classification of craniofacial malformations. Craniofacial malformationsGoogle Scholar
  36. 36.
    Van der Meulen JC, Mazzola R et al (1983) A morphogenetic classification of craniofacial malformations. Plast Reconstr Surg 71(4):560–572Google Scholar
  37. 37.
    Vanwijck R, Bayet B et al (2002) La prise en charge primaire et secondaire des fentes labio-palatines au centre labio-palatin de Bruxelles. Ann Chir Plast Esthet, Elsevier 47(2):126–133Google Scholar
  38. 38.
    Vermeij-Keers C (1990) Craniofacial embryology and morphogenesis: normal and abnormal. Craniofacial malformations. Churchill Livingstone, Edinburgh, pp 27–60Google Scholar
  39. 39.
    Vermeij-Keers C, Mazzola RF et al (1983) Cerebro-craniofacial and craniofacial malformations: an embryological analysis. Cleft Palate J 20(2):128–145Google Scholar
  40. 40.
    Zhou YQ, Ji J et al (2006) Diagnosis and classification of congenital craniofacial cleft deformities. J Craniofac Surg 17(1):198–201Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryCURCP, University Hospital Center of the Canton of Vaud (CHUV)LausanneSwitzerland
  2. 2.Department of Ophtalmology, Jules Gonin HospitalUniversity Hospital Center of the Canton of Vaud (CHUV)LausanneSwitzerland

Personalised recommendations