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特西尔7号裂:病例报告中的临床表现与手术矫正

Tessier 7 Cleft: Clinical Presentation and Surgical Correction in a Case Report.

作者信息

Mannali Anup R, M Pasupathy, Kumar Satish

机构信息

Plastic and Reconstructive Surgery, SRM Medical College and Research Centre, Chennai, IND.

Cleft Lip and Palate Reconstructive Surgery, SRM Medical college Hospital and Research Centre, Chennai, IND.

出版信息

Cureus. 2024 Oct 8;16(10):e71062. doi: 10.7759/cureus.71062. eCollection 2024 Oct.

DOI:10.7759/cureus.71062
PMID:39512951
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11541645/
Abstract

Tessier 7 cleft, or transverse facial cleft, is a rare congenital anomaly involving lateral facial tissues, often resulting from embryonic disruptions in the first and second branchial arches. It presents varying severities from macrostomia to complete clefts affecting soft tissue and skeletal structures. Surgical management is challenging, requiring a multidisciplinary approach for functional and aesthetic reconstruction. This case report discusses a patient's presentation, surgical intervention, and outcomes. Our case report describes a rare form of Tessier cleft in a one-and-a-half-year-old male child with no syndromic association. This was diagnosed by clinical evaluation, and radiological modalities and managed surgically. Tessier 7 cleft, or transverse facial cleft, is a rare anomaly extending from the mouth to the ear, resulting from abnormal fusion of facial processes during embryonic development. It ranges from mild macrostomia to severe deformities affecting soft tissues and bone. Surgical management aims to restore facial symmetry, function, and aesthetics, often requiring multiple procedures. Challenges include maintaining oral competence and achieving satisfactory cosmetic results. A multidisciplinary approach is essential, involving plastic surgeons, orthodontists, and speech therapists, with long-term follow-up to monitor development and outcomes. Early diagnosis is the key to achieving an acceptable functional and aesthetic outcome in children. Surgical correction should be done at the earliest for oral competency and normal speech development.

摘要

泰西埃7型腭裂,即面部横向腭裂,是一种罕见的先天性畸形,累及面部外侧组织,通常由第一和第二鳃弓的胚胎发育紊乱引起。其严重程度各不相同,从大口畸形到影响软组织和骨骼结构的完全腭裂。手术治疗具有挑战性,需要多学科方法进行功能和美学重建。本病例报告讨论了一名患者的临床表现、手术干预及结果。我们的病例报告描述了一名1岁半男性儿童患有一种罕见形式的泰西埃腭裂,且无综合征关联。通过临床评估和影像学检查确诊,并进行了手术治疗。泰西埃7型腭裂,即面部横向腭裂,是一种罕见的畸形,从口腔延伸至耳部,由胚胎发育过程中面部突起的异常融合引起。其范围从轻度大口畸形到影响软组织和骨骼的严重畸形。手术治疗旨在恢复面部对称性、功能和美观,通常需要多次手术。挑战包括维持口腔功能以及获得满意的美容效果。多学科方法至关重要,涉及整形外科医生、正畸医生和言语治疗师,并需要长期随访以监测发育情况和治疗结果。早期诊断是儿童获得可接受的功能和美学效果的关键。应尽早进行手术矫正,以实现口腔功能和正常言语发育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/38612d9d9ca0/cureus-0016-00000071062-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/7633959aac08/cureus-0016-00000071062-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/c4e06dcbddb1/cureus-0016-00000071062-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/c02dcfddbfb0/cureus-0016-00000071062-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/0739b321bda6/cureus-0016-00000071062-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/38612d9d9ca0/cureus-0016-00000071062-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/7633959aac08/cureus-0016-00000071062-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/c4e06dcbddb1/cureus-0016-00000071062-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/c02dcfddbfb0/cureus-0016-00000071062-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/0739b321bda6/cureus-0016-00000071062-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11541645/38612d9d9ca0/cureus-0016-00000071062-i05.jpg

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1
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本文引用的文献

1
Surgical management of the Tessier 7 cleft: A review and presentation of 5 cases.Tessier 7 型腭裂的外科治疗:5例病例回顾与报告
JPRAS Open. 2019 Jul 23;22:9-18. doi: 10.1016/j.jpra.2019.07.004. eCollection 2019 Dec.
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Bilateral Tessier's 7 Cleft with Maxillary Duplication.双侧泰西埃7号裂伴上颌骨重复畸形
J Maxillofac Oral Surg. 2015 Mar;14(Suppl 1):108-12. doi: 10.1007/s12663-012-0346-x. Epub 2012 Mar 27.
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Repair for congenital macrostomia: vermilion square flap method.先天性大口畸形修复术:唇红方形皮瓣法
Case Rep Dent. 2014;2014:480598. doi: 10.1155/2014/480598. Epub 2014 May 29.
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Tessier no. 7 cleft: a new subclassification and management protocol.泰西埃7号腭裂:一种新的亚分类及治疗方案
Plast Reconstr Surg. 2008 Sep;122(3):898-905. doi: 10.1097/PRS.0b013e3181811cb6.
5
Tessier number 7 cleft with oblique clefts of bilateral soft palates and rare symmetric structure of zygomatic arch.第7号特西尔裂,伴有双侧软腭斜裂以及罕见的对称颧骨弓结构。
J Plast Reconstr Aesthet Surg. 2008;61(4):447-50. doi: 10.1016/j.bjps.2006.05.019. Epub 2006 Sep 6.
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Anatomical classification facial, cranio-facial and latero-facial clefts.面部、颅面部和侧面部裂的解剖学分类。
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