Arch Plast Surg.  2019 Jan;46(1):16-22. 10.5999/aps.2018.01193.

Surgical correction for Tessier number 7 craniofacial cleft using a medially overcorrected design

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. bccho@knu.ac.kr

Abstract

BACKGROUND
Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure.
METHODS
A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry.
RESULTS
Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was 78.273±72.219 months and the mean ratio of the lengths of both sides of the lip was 1.048±0.071. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred.
CONCLUSIONS
For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.

Keyword

Orofacial cleft 7; Macrostomia; Surgical procedures, operative

MeSH Terms

Ambulatory Care Facilities
Cicatrix
Cleft Palate
Congenital Abnormalities
Ear
Follow-Up Studies
Goldenhar Syndrome
Gyeongsangbuk-do
Hemorrhage
Humans
Lip
Macrostomia
Medical Records
Plastics
Postoperative Complications
Retrospective Studies
Sex Ratio
Skin
Surgeons
Surgical Procedures, Operative
Wound Infection
Wounds and Injuries
Plastics
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