Division of Plastic Surgery, 138334Albany Medical Center, Albany, NY, USA.
Pediatric Plastic Surgery, Children's Hospital and Medical Center & 12284University of Nebraska Medical Center, Omaha, NE, USA.
Cleft Palate Craniofac J. 2021 Sep;58(9):1094-1101. doi: 10.1177/1055665620984045. Epub 2021 Feb 22.
The authors present findings and techniques to address hemipalatal discrepancy in patients with Tessier 7 cleft and associated cleft palate during cleft palatoplasty.
The authors report 2 cases of pediatric patients with Tessier 7 facial clefts and associated cleft palate. One patient presents on the broader oculo-auriculo-vertebral spectrum and the other is has isolated Tessier cleft 7. Additionally, a PubMed search was performed using the MeSH terms "tessier 7," "cleft palate", "macrostomia," "tessier 7 AND cleft palate," "macrostomia AND cleft palate," AND "hemipalatal discrepancy." All relevant literature was identified and underwent full review for qualitative analysis.
Two patients met criteria for inclusion in this article. The surgical techniques utilized to mitigate the hemipalatal length discrepancy are detailed, and intraoperative photographs are provided. The results of the literature review are also presented. Tessier 7 craniofacial cleft and palatal clefts, when occurring in combination, is noted to result in discrepant hemipalatal length with short maxillary palate length on the affected side as well hypoplasia of the associated speech musculature. The postoperative palatal length after palatoplasty in both patients was longer than the preoperative hypoplastic palatal length.
When occurring in combination, Tessier 7 craniofacial cleft and concomitant palatal cleft results in discrepant hemipalatal length, and deficiency of the bony maxillary palatal shelves, and associated speech musculature and soft tissues. The techniques described in this article may assist in maximizing postoperative palatal length.
作者提出了在腭裂修复术中解决 7 型面裂及相关腭裂患者半侧腭裂差异的发现和技术。
作者报告了 2 例儿科患者的 7 型面裂及相关腭裂。1 例患者表现为较宽的眼耳颌脊柱谱系，另 1 例为孤立性 7 型 Tessier 裂。此外，还使用 MeSH 术语“tessier 7”、“cleft palate”、“macrostomia”、“tessier 7 AND cleft palate”、“macrostomia AND cleft palate”和“hemipalatal discrepancy”在 PubMed 上进行了搜索。所有相关文献均被确定并进行了全面审查，以进行定性分析。
有 2 名患者符合纳入本文的标准。详细介绍了用于减轻半侧腭裂长度差异的手术技术，并提供了术中照片。还介绍了文献复习的结果。当 7 型颅面裂和腭裂同时发生时，会导致腭裂侧半侧腭裂长度差异，上颌腭长度短，相关言语肌肉发育不良。在这 2 名患者中，腭裂修复术后的腭长度均长于术前发育不良的腭长度。
当 7 型颅面裂和并发腭裂同时发生时，会导致半侧腭裂长度差异、上颌骨腭骨支架骨缺损以及相关言语肌肉和软组织缺损。本文描述的技术可能有助于最大限度地增加术后腭长度。
