Department of Maxillofacial Surgery, University Hospital Center, Place Victor Pauchet, 80054, Amiens Cedex 1, France; University of Picardie Jules Verne, Pôle santé 3, Rue des Louvels, 80036, Amiens Cedex 1, France.
Department of Maxillofacial Surgery, University Hospital Center, Place Victor Pauchet, 80054, Amiens Cedex 1, France; Facing Faces Institute, Amiens University Hospital Center, Place Victor Pauchet, 80054, Amiens Cedex 1, France.
J Craniomaxillofac Surg. 2018 Jan;46(1):22-27. doi: 10.1016/j.jcms.2017.10.012. Epub 2017 Oct 27.
Craniofacial clefts belong to the most disfiguring and rare congenital malformations of the face and among these, orbito-facial clefts constitute approximately 0.22 % of the cases with Tessier cleft number 5 being the least common. Our aim was to define the phenotypic spectrum for this subgroup to improve clinical management.
Our study group consisted of four patients which were treated at two different cleft centers. Retrospective chart review and anatomical analysis were conducted for each patient based on clinical evaluation and imaging studies. Morphological anomalies including soft tissue, bone and oral components were recorded.
Based on our analysis and literature review, we could define two subtypes of Tessier facial cleft number 5. (1) Medial clefts are the more severe subtype, creating a significant soft tissue and bone defect that runs vertically, through the eyelid, infraorbital rim, maxillary sinus and cheek. They have the poorer esthetic and functional prognosis, due to orbital dystopia and absence of lower eyelid. (2) Lateral clefts are a less severe subtype characterized by the presence of a vertical furrow of the cheek running laterally to the maxillary sinus.
We identified two subtypes of facial cleft number 5 which require an individualized surgical management.
颅面裂属于最具毁容性和罕见的面部先天畸形，其中眼眶-面裂约占病例的 0.22%，而泰瑟 5 号裂则是最不常见的。我们的目的是定义该亚组的表型谱，以改善临床管理。
我们的研究组由在两个不同的裂隙中心接受治疗的 4 名患者组成。对每位患者进行回顾性图表审查和解剖分析，依据临床评估和影像学研究。记录了包括软组织、骨骼和口腔成分在内的形态异常。
根据我们的分析和文献复习，我们可以将泰瑟 5 号面裂定义为两种亚型。（1）内侧裂隙是更严重的亚型，在垂直方向上穿过眼睑、眶下嵴、上颌窦和脸颊，形成明显的软组织和骨骼缺损。由于眼眶移位和下眼睑缺失，它们的美观和功能预后较差。（2）外侧裂隙是一种较轻的亚型，其特征是在脸颊上有一个垂直的凹槽，向侧面延伸到上颌窦。
我们确定了泰瑟 5 号面裂的两种亚型，需要个体化的手术管理。
