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Rare craniofacial clefts: Tessier no. 4 clefts.
Plast Reconstr Surg. 1990 Jun; 85(6):843-9; discussion 850-2.PR

Abstract

A major difficulty in understanding rare craniofacial clefts arises from the fact that previous reports have focused on a single case or have grouped together different types of rare clefts. Less than 50 Tessier no. 4 clefts have been reported. This paper examines our experience with eight patients treated primarily or secondarily for Tessier no. 4 clefts. A treatment plan is recommended. The primary early concern is protection of the eye. Early correction of soft-tissue deformities should include skin, muscle, and lining of the orbit, cheek, and oral cavity. Contrary to the dictum that all soft tissue must be preserved, the medial portion of the upper lip from the cleft to the philtral ridge must be resected to prevent poorly camouflaged scars, muscle deficiency, and macrostomia. Bone grafting should be undertaken at an early age using calvarial bone. Late operations will be necessary for correction of medial and lateral canthal position, epiphora, lower eyelid skin deficiency, and further bony augmentation.

Authors+Show Affiliations

Division of Plastic Surgery, UCLA School of Medicine.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2349290

Citation

Resnick, J I., and H K. Kawamoto. "Rare Craniofacial Clefts: Tessier No. 4 Clefts." Plastic and Reconstructive Surgery, vol. 85, no. 6, 1990, pp. 843-9; discussion 850-2.
Resnick JI, Kawamoto HK. Rare craniofacial clefts: Tessier no. 4 clefts. Plast Reconstr Surg. 1990;85(6):843-9; discussion 850-2.
Resnick, J. I., & Kawamoto, H. K. (1990). Rare craniofacial clefts: Tessier no. 4 clefts. Plastic and Reconstructive Surgery, 85(6), 843-9; discussion 850-2.
Resnick JI, Kawamoto HK. Rare Craniofacial Clefts: Tessier No. 4 Clefts. Plast Reconstr Surg. 1990;85(6):843-9; discussion 850-2. PubMed PMID: 2349290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rare craniofacial clefts: Tessier no. 4 clefts. AU - Resnick,J I, AU - Kawamoto,H K,Jr PY - 1990/6/1/pubmed PY - 2001/3/28/medline PY - 1990/6/1/entrez SP - 843-9; discussion 850-2 JF - Plastic and reconstructive surgery JO - Plast Reconstr Surg VL - 85 IS - 6 N2 - A major difficulty in understanding rare craniofacial clefts arises from the fact that previous reports have focused on a single case or have grouped together different types of rare clefts. Less than 50 Tessier no. 4 clefts have been reported. This paper examines our experience with eight patients treated primarily or secondarily for Tessier no. 4 clefts. A treatment plan is recommended. The primary early concern is protection of the eye. Early correction of soft-tissue deformities should include skin, muscle, and lining of the orbit, cheek, and oral cavity. Contrary to the dictum that all soft tissue must be preserved, the medial portion of the upper lip from the cleft to the philtral ridge must be resected to prevent poorly camouflaged scars, muscle deficiency, and macrostomia. Bone grafting should be undertaken at an early age using calvarial bone. Late operations will be necessary for correction of medial and lateral canthal position, epiphora, lower eyelid skin deficiency, and further bony augmentation. SN - 0032-1052 UR - https://www.unboundmedicine.com/medline/citation/2349290/Rare_craniofacial_clefts:_Tessier_no__4_clefts_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=2349290.ui DB - PRIME DP - Unbound Medicine ER -