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Tessier no. 7 cleft: a new subclassification and management protocol.

Roger H Woods1, Sanjay Varma, David J David

  • 1Adelaide, South Australia, Australia From the Australian Craniofacial Unit, Women's and Children's Hospital.

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This study reviews Tessier no. 7 clefts, a rare craniofacial condition. An adjusted management protocol for bony abnormalities and duplication shows favorable outcomes for patients.

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Area of Science:

  • Craniofacial Surgery
  • Pediatric Plastic Surgery
  • Congenital Anomalies

Background:

  • Tessier no. 7 clefts are rare lateral facial clefts involving macrostomia and bony abnormalities.
  • Computed tomography provided initial insights into the bony defects.
  • Optimal management protocols require further definition.

Purpose of the Study:

  • To review clinical and radiological features of Tessier no. 7 clefts.
  • To advise on optimal management protocols for this patient group.
  • To propose a new subclassification for bony abnormalities.

Main Methods:

  • Retrospective case-note review of 15 patients with Tessier no. 7 clefts over 25 years.
  • Exclusion of hemifacial microsomia and Treacher-Collins syndrome.
  • Analysis of clinical features via photography and imaging; review of surgical management and outcomes.

Main Results:

  • 15 patients with 18 clefts (3 bilateral) were treated.
  • Macrostomia (mean length 2 cm) and soft-tissue ridging were common.
  • Bony abnormalities included maxillary clefting (55%), duplication (39%), and fusion (6%).
  • Surgical interventions included macrostomia repair, maxillary duplication resection, and alveolar bone grafting.
  • Good functional and aesthetic results were achieved with the protocol.

Conclusions:

  • Detailed description of Tessier no. 7 clefts.
  • Proposal of a new subclassification for bony abnormalities.
  • An adjusted management protocol for cleft and duplication resulted in favorable outcomes.