Atypical Facial Clefts From Northcentral Nigeria,Review of 36 Cases

Abstract

Objective:

This study aims to present the pattern and management of atypical facial clefts from a Nigerian population.

Design:

This is a retrospective study of patients seen during series of surgical outreach programs in North Central Nigeria, between 2011 and 2017. All cases of atypical facial clefts encountered were evaluated for the pattern of presentation using Tessier classification system. All of them were surgically repaired and outcome was determined using a Likert scale. Data were presented using descriptive statistics.

Setting:

Outreach programs in North Central Nigeria by Cleft & Facial Deformity Foundation.

Results:

Thirty-six patients, 19 (52.8%) males and 17 (47.2%) females, were studied. The age range was 1 week to 34 years, with mean (standard deviation) of 11.2 (11.8) years. Fifty-eight cleft cases were recorded, with Tessier 1 being the commonest (n = 14; 24.1%) cleft type. There were 35 (60.3%) cases of middle cleft, 14 (24.2%) cases of oblique cleft, and 9 (15.5%) cases of lateral cleft. Typical cleft lip and palate coexisted with atypical facial cleft in 2 (5.6%) patients. Cleft was found to be median in 12 (33.3%) patients and right sided in 9 (25%) patients. Majority (n = 24, 66.7%) of the cases were repaired by simple excision plus direct closure with successful outcome.

Conclusions:

Numerical classification by Paul Tessier has reduced the inconsistencies of nomenclature among practitioners. Majority of atypical facial clefts could be treated by simple techniques with satisfactory outcomes. However, the more complex cases will require multistaged surgical approach.

Keywords

atypical facial clefts Northcentral Nigeria cleft repair

Get full access to this article

View all access options for this article.

References

Abdollahifakhim

Shahidi

Bayazian

. A bilateral Tessier number 4 and 5 facial cleft and surgical strategy: a case report. Iran J Otorhinolaryngol. 2013;25(73):259–262.

Adeyemo

Ogunlewe

Desalu

Ladeinde

Mofikoya

Adeyemi

Adepoju

Hassan

. Cleft deformities in adults and children aged over six years in Nigeria: reasons for late presentation and management challenges. Clin Cosmet Investig Dent. 2009;1:63–69.

Allam

Lim

Elsherbiny

Kawamoto

. The Tessier number 3 cleft: a report of 10 cases and review of literature. J Plast Reconstr Aesthet Surg. 2014;67(8):1055–1062.

Aziz

Rhee

Redai

. Cleft surgery in rural Bangladesh: reflections and experiences. J Oral Maxillofac Surg. 2009;67(8):1581–1588.

Bradley

Kawamoto

. Craniofacial clefts and hypertelorbitism. In: Thorne

, ed. Grabb and Smith’s Plastic Surgery. 6th ed. Philadelphia: Lippincott, Williams & Wilkins; 2007:268–280. Chapter 28.

Costa

Borzabadi-Farahani

Lara-Sanchez

Schweitzer

Jacobson

Clarke

Hammoudeh

Urata

Magee

. Partial craniofacial duplication: a review of the literature and case report. J Craniomaxillofac Surg. 2014;42(4):290–296. doi:10.1016/j.jcms.2013.05.016.

Donkor

Bankas

Agbenorku

Plange-Rhule

Ansah

. Cleft lip and palate in Kumasi, Ghana: 2001-2005. J Craniofac Surg. 2007;18(6):1376–1379.

Fan

Mulliken

Padwa

. An association between hemifacial microsomia and facial clefting. J Oral Maxillofac Surg. 2005;63(3):330–334.

Fijałkowska

Antoszewski

. Rare facial clefts. Pol Przegl Chir. 2015;87(8):389–394.

10.

Fogh-Andersen

. Rare clefts of the face. Acta Chir Scand. 1965;129:275–281.

11.

Gawrych

Janiszewska-Olszowska

Chojnacka

. Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate. Int J Oral Maxillofac Surg. 2010;39(11):1133–1136.

12.

Isika

Tercanb

Bekerecioglu

. Tessier No. 7 unilateral cleft: two case reports. East J Med. 2011;16(2011):90–93.

13.

Kawamoto

Wang

MKH

Macomber

. Converse: Chapter 46—Rare craniofacial clefts. 2016. http://famona.sezampro.rs/medifiles/plastic/converse/co462116.pdf. 1–32. Accessed November, 2016.

14.

Mazzola

. Congenital malformations in the frontonasal area: their pathogenesis and classification. Clin Plast Surg. 1976;3(4):573–609.

15.

Mazzola

. Facial clefts and facial dysplasia: revisiting the classification. J Craniofac Surg. 2014;25(1):26–34.

16.

Murray

. Face facts: genes, environment, and clefts. Am J Hum Genet. 1995;57(2):227–232.

17.

Ortube

Dipple

Setoguchi

Kawamoto

Jr Demer

. Ocular manifestations of oblique facial clefts. J Craniofac Surg. 2010;21(5):1630–1631.

18.

Patel

Tantri

. Median cleft of the upper lip: a rare case. Cleft Palate Craniofac J. 2010:47(6);642–644.

19.

Pitanguy

. Facial Clefts as Seen in a Large Series of Untreated Adults and Their Later Management. London: Pitman; 1968.

20.

Popescu

. Congenital transverse facial clefts. Rom Med Rev. 1968;12(4):75–85.

21.

Population census. 2006. http://population.gov.ng/core-activities/surveys/dataset/2006-phc-priority-tables. Accessed June 4, 2017.

22.

Poswillo

. The pathogenesis of the first and second branchial arch syndrome. Oral Surg Oral Med Oral Pathol. 1973;35(3):302–328.

23.

Rawashdeh

Abu-Hawas

. Congenital associated malformations in a sample of Jordanian patients with cleft lip and palate. J Oral Maxillofac Surg. 2008;66(10):2035–2041.

24.

Stelnicki

Hoffman

Vanderwall

Harrison

Foster

Longaker

. A new in utero model for lateral facial clefts. J Craniofac Surgery. 1997;8(6):460–465.

25.

Subramani

Murthy

. A classification of cranio facio cervical (branchial) clefts (Bangalore classification). Indian J Plast Surg. 2005;38(2):79–94.

26.

Tessier

. Fentes orbito-faciales verticales et obliques (colobomas) completes et frustes. Annales de Chirurgie Plastique. 1969;14:301.

27.

Vanderas

. Incidence of cleft lip, cleft palate, and lip and palate among races: a review. Cleft Palate J. 1987;24(3):216–225.

28.

Van den elzen

Versnel

Wolvius

van Veelen

Vaandrager

van der Meulen

Mathijssen

. Long-term results after 40 years’ experience with treatment of rare facial clefts: part 2—symmetrical median clefts. J Plast Reconstr Aesthet Surg. 2011;64(10):1344–1352.

29.

Verdi

Hersh

Russell

. Partial duplication of the face: case report and review. Plast Reconstr Surg. 1991;87(4):759–762.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.16 MB

0.20 MB