Among the rarest of the craniofacial clefts is the Tessier no. 4 cleft; and hence little has been published about its management and treatment. Complete forms of the cleft yield poor surgical results because of the shortened oculoalar and oculo-oral distance and inadequate soft and bony tissue. Multiple sequential corrective operations are required. A primary early concern is the protection of the eye, particularly in severe forms in which corneal exposure occurs. This article presents two cases of Tessier no. 4 clefts, one unilateral and the other bilateral, and discusses the problems encountered during their surgical and postoperative managements.
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2.
GarabedianE.N., DucrozV., RogerG., DenoyelleF., CatalaM.. Nasal fossa malformations and para median facial cleft: new perspect.J Craniofac Genet Dev Biol.1999; 19: 12–19.
MenardR.M., MooreM.H., DavidD.J.. Tissue expansion in the reconstruction of Tessier craniofacial clefts: a series of 17 patients.Plast Reconstr Surg.1999; 103: 779–786.
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