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

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.