Repair of Tessier no. 3 and no. 4 craniofacial clefts with facial unit and muscle repositioning by midface rotation advancement without Z-plasties

Plastic and Reconstructive Surgery
Philip Kuo-Ting ChenM Samuel Noordhoff

Abstract

The accepted surgical correction of Tessier no. 3 and no. 4 craniofacial clefts is the use of interdigitating skin flaps along the line of the facial cleft, which frequently results in unsightly facial scars, poor skin color match, and an unnatural facial expression. The authors report their technique of midface rotation-advancement concept to repair these craniofacial clefts. Fourteen patients who had undergone Tessier no. 3 and no. 4 cleft repair over a 35-year period (1976 to 2010) at the craniofacial center in Chang Gung Memorial Hospital were retrospectively reviewed. Five patients (group 1) were operated on using Z-plasty principles. Nine (group 2) were operated on using the rotation-advancement technique; six of them had Tessier no. 3 clefts and three had Tessier no. 4 clefts. Seven of those nine patients were primary cases; the other two had secondary or tertiary revisions. Patient photographs were reviewed to assess outcomes. Group 1 had a less overall satisfactory result in terms of scar quality, color matching, or natural facial expression. Overall, a much improved appearance with a higher satisfaction rate was demonstrated in group 2. Patients in group 2 who were surgically treated with the midface rotation advancem...Continue Reading

References

Jun 1, 1990·Plastic and Reconstructive Surgery·J I Resnick, H K Kawamoto
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May 1, 1996·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·T AközF Dağ
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Jul 10, 2009·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Boris LaureDominique Goga

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Citations

Dec 3, 2014·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Taku MaedaYuhei Yamamoto
Jul 15, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·John L SpolyarJ Camilo Roldán
Jun 30, 2015·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Elçin EsenlikJohn L Spolyar
Sep 9, 2016·The Journal of Craniofacial Surgery·Mona AschaGregory E Lakin
Dec 23, 2016·The Journal of Craniofacial Surgery·Ugur HorozShinya Yoshimoto
Aug 13, 2015·The Journal of Craniofacial Surgery·Benjamin C WoodSuresh N Magge
Dec 23, 2016·The Journal of Craniofacial Surgery·Aaron L MorganChristian A El Amm
May 11, 2018·Maxillofacial Plastic and Reconstructive Surgery·Ji-Hyeon Oh, Young-Wook Park
Feb 3, 2021·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Harinder S ChahalA Tyrone Glover

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