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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.
- Source :
- Journal of Cranio-Maxillofacial Surgery; Sep2015, Vol. 43 Issue 7, p1261-1268, 8p
- Publication Year :
- 2015
-
Abstract
- Background 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. Methods 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. Results 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. Conclusions 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10105182
- Volume :
- 43
- Issue :
- 7
- Database :
- Supplemental Index
- Journal :
- Journal of Cranio-Maxillofacial Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 108966677
- Full Text :
- https://doi.org/10.1016/j.jcms.2015.06.002