Arch Craniofac Surg.  2019 Aug;20(4):255-259. 10.7181/acfs.2019.00276.

Soft tissue reconstruction in wide Tessier number 3 cleft using the straight-line advanced release technique

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. plasrecon@gmail.com

Abstract

Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

Keyword

Cleft lip; Cleft palate; Congenital abnormality; Craniofacial abnormality; Reconstructive surgical procedure

MeSH Terms

Classification
Cleft Lip
Cleft Palate
Congenital Abnormalities
Craniofacial Abnormalities
Eyelids
Maxillary Sinus
Orbit
Rare Diseases
Reconstructive Surgical Procedures
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