Zhang Zheng, Hou Zhijia, Wang Yue, Ma Lan, Li Dongmei
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
J Craniofac Surg. 2025 Sep 1;36(6):1916-1920. doi: 10.1097/SCS.0000000000011373. Epub 2025 Apr 7.
Tessier no. 3 and no. 4 clefts are rare and difficult-to-treat orbitofacial malformations. The aim of the present study is to describe the clinical manifestations of these rare clefts observed in 21 patients treated with surgery over the past 15 years.
The clinical data of all patients with Tessier no. 3 and no. 4 clefts treated between 2009 and 2024 by a single senior surgeon were reviewed. The patient's demographic data and associated clinical findings, including eyelid, lacrimal system, and eyeball anomalies, were recorded. The reconstruction methods used for each patient were noted and evaluated retrospectively.
This study included 21 eyes of 21 patients with Tessier no. 3 and no. 4 clefts who underwent plastic surgery. Eight males and thirteen females were identified, and the age at initial treatment ranged from 1 to 20 years. A lower eyelid coloboma was observed in most patients (14 patients); 12 of whom presented with medial canthus dystopia. Seven patients presented with isolated medial canthus dystopia. Thirteen patients had lacrimal system anomalies. Microphthalmia and ipsilateral anophthalmia were detected in 5 and 3 patients, respectively. Satisfactory esthetic and functional outcomes were achieved in all patients owing to the use of traditional techniques and techniques modified by the authors.
The clinical manifestations of Tessier no. 3 and no. 4 facial clefts vary, thus treatment plans and techniques must be personalized to meet the needs for each patient.
摘要 背景：第3型和第4型Tessier腭裂是罕见且难以治疗的眶面部畸形。本研究的目的是描述过去15年中接受手术治疗的21例患者中观察到的这些罕见腭裂的临床表现。
回顾了2009年至2024年间由一位资深外科医生治疗的所有第3型和第4型Tessier腭裂患者的临床资料。记录患者的人口统计学数据和相关临床发现，包括眼睑、泪道系统和眼球异常。回顾性记录并评估每位患者使用的重建方法。
本研究纳入了21例接受整形手术的第3型和第4型Tessier腭裂患者的21只眼。确定了8名男性和13名女性，初始治疗年龄为1至20岁。大多数患者（14例）观察到下睑缺损；其中12例伴有内眦移位。7例患者表现为孤立性内眦移位。13例患者有泪道系统异常。分别在5例和3例患者中检测到小眼症和同侧无眼症。由于使用了传统技术和作者改良的技术，所有患者均取得了满意的美学和功能效果。
第3型和第4型面部腭裂的临床表现各不相同，因此治疗方案和技术必须个性化以满足每位患者的需求。
