Bilateral Tessier Craniofacial Cleft Associated to Cleft Palate

Area of Science:

• Craniofacial Surgery
• Pediatric Plastic Surgery
• Medical Missions

Background:

• Presents a rare case of Tessier number 4 and 5 facial clefts with a palatal cleft in a 4-month-old infant.
• The patient also had bilateral facial clefts and right anophthalmia, requiring a staged surgical approach.
• The case was managed during a humanitarian mission in Sabou, Burkina Faso, highlighting challenges in resource-limited settings.

Purpose of the Study:

• To report a rare craniofacial anomaly.
• To describe the surgical management of complex facial clefts in an infant.
• To emphasize the role of humanitarian missions in treating underserved populations.

Main Methods:

• A 2-step surgical approach was planned for the infant.
• The first surgery involved modified unilateral cleft lip repair and Z-plasty for the Tessier number 5 cleft.
• Palatoplasty was planned for a subsequent mission.

Main Results:

• The initial surgery for facial clefts yielded excellent outcomes.
• Improvements in facial aesthetics and ocular protection were observed post-surgery.
• The case underscores the feasibility of managing complex deformities in challenging environments.

Conclusions:

• Tessier clefts have an uncertain etiology, potentially involving genetic and environmental factors.
• Effective surgical management is possible even in resource-limited settings.
• Humanitarian missions are crucial for providing specialized care to patients with limited access.