Document Detail


Tessier no. 4 facial cleft: evolution of surgical treatment in a large series of patients.
MedLine Citation:
PMID:  18971735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: : Tessier no. 4 facial cleft is a rare, complex, and challenging craniofacial malformation. The present article aims to describe different clinical features evidenced in 21 cases of this malformation, discussing a 20-year experience with and evolution of its surgical treatment.
METHODS: : Some demographic data, clinical features, and reconstructive results were evaluated retrospectively. These patients have been evaluated and treated in three specialized Brazilian craniofacial centers. Nineteen were already operated on, with a mean follow-up of 3.5 years (range, 1 to 20 years).
RESULTS: : Sex distribution showed a male prevalence (2:1). The average age of initial treatment was 5.4 years. Four cases were affected on the right side of the face, seven on the left, and 10 bilaterally. Six patients had other rare associated facial clefts, including nos. 5 (three patients), 7, 9, and 10. Cleft upper lip was evidenced in all patients, and maxillary hypoplasia was present in five and maxilla cleft in eight. Lower eyelid coloboma was seen in almost every case (19 patients); 10 of these had medial canthus dystopia. Four patients had amniotic bands in the limbs. Surgical repair was individualized to each patient. Surgical experience gained with these patients allowed the authors to develop some technical modifications, which have improved aesthetic results, camouflaging scars into natural folds and anatomical units, without compromising functional outcomes.
CONCLUSIONS: : The great majority of Tessier no. 4 facial clefts can be appropriately treated using local flaps. Classic techniques are extremely useful, but long-term results could be improved if the technical modifications described were adopted.
Authors:
Nivaldo Alonso; Renato da Silva Freitas; Gilvani Azor de Oliveira e Cruz; Dov Goldenberg; Andre Ricardo Dall'oglio Tolazzi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  122     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2008-11-26     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1505-13     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Cleft Lip / epidemiology,  pathology,  surgery*
Coloboma / pathology,  surgery*
Eyelids / abnormalities,  surgery
Face / abnormalities*,  surgery*
Facial Bones / abnormalities,  surgery
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Reconstructive Surgical Procedures / methods*
Retrospective Studies
Sex Distribution
Surgical Flaps

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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