Cleft - Ultimate Treatment
Oblique facial cleft - The ULTIMATE Clinical pearls To achieve the best possible clinical outcomes in oblique facial clefts various aspects have to be considered. Ignoring one or more of these aspects may lead to suboptimal aesthetic and functional results. 1. Oblique facial clefts are rare with a prevalence of 1.4%. The median and lateral facial clefts are excluded from these statistics. They are classified under standard clefts although they are Tessier 0 and Tessier 7 clefts. 2. Each oblique facial cleft has a different appearance with a different tissue deficiency. As such, their reconstruction always entails different designs to achieve optimal surgical outcomes. 3. Depending what tissue is most lacking, structures like eyes, eyelids, tear ducts, nasal cutaneous tissue, nasal bones, zygoma and maxilla, need to be considered during surgical planning, to achieve the best possible outcome. Quite often tissue expanders and lip adhesion are needed before major facial reconstruction can take place. 4. The reconstruction of the medial canthal ligament position with wires attached to bilateral miniplates and/or screws, represents one of the most essential parts in eyelid positioning and the surrounding soft tissue(s). 5. The ultimate result depends very much on the type of lacking tissue, the surgical design and the repositioning of the available soft tissue. It is impossible to make a long-term prediction for the sagging and limited growth of the repositioned soft tissue.
Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...