Postoperative Analysis of The Tessier Classification No.7 Cleft Patient

Lee, Jang Ho; Lee, Keun Cheol; Park, Jung Min; Kim, Seok Kwun

Abstract

Tessier classification No. 7 facial cleft which originates from incomplete fusion between maxillary process and mandibular process at 8~12 week embryo is also called as transverse facial cleft or lateral facial cleft. Typical appearance of No. 7 facial cleft, mouth commissure is not hanging to the front and cleft is lay behind so that deformity become prominent when mouth is open. This malformation varies from simple unilateral enlargement of mouth corner to large cleft that begin mouth commissure and reach the tragus but the method of surgery is similar. Because of low prevalence and few study of No. 7 facial cleft in Korea, clinical assessment is limited. However, we tried to evaluate the functional and cosmetic aspect of twelve No. 7 facial cleft patients who underwent Surgery in recent 10 years. Most of them were corrected with Z-plasty and orbicularis oris muscle repair. Most of the children were below 1 years and only one of them was 11 years old and follow up period is from 3 months to 6 years. We researched and analyzed clinical feature, postoperative result, satisfaction score through medical records, pre and postoperative pictures of the lesion, consultation. We obtained better satisfactory result in both cosmetic & functional aspects through Z-plasty without changing the mouth commissure when mouth is open. 8 cases of them needed synchronous surgery for accessory tragus. 4 cases of them had hemifacial microsomia and 3 cases of them had microtia. We performed Z-plasty with orbicularis oris muscle repair to minimize the scar and to correct the shape and function of the mouth commissure become normal. Thus, We were able to obtain satisfactory result from this study.