Congenital macrostomia, or Tessier number 7 cleft, is a rare craniofacial anomaly. We present a unique patient with bilateral macrostomia that consisted of a “double” transverse cleft on the left side and a single transverse cleft on the right side. A staged reconstructive approach was used to repair the “double” left-sided clefts. This staged technique produced a satisfactory aesthetic and functional outcome.
BuonocoreS.BroerP.N.WalkerM.E.da Silva FreitasR.FrancoD.AlonsoN.Macrostomia: a spectrum of deformity. Ann Plast Surg. 2014; 72: 363–368.
4.
ButowK.W.BothaA.A classification and construction of congenital lateral facial clefts. J Craniofac Surg. 2010; 38: 477–484.
5.
EguchiT.AsatoP.H.TakushimaA.TakatoT.HariiP.K.Surgical repair for congenital macrostomia: vermillion square flap method. Ann Plast Surg. 2001; 47: 629–635.
6.
FanW.S.MullikenJ.B.PadwaB.L.An association between hemifacial microsomia and facial clefting. J Oral Maxillofac Surg. 2005; 63: 330–334.
7.
GleizalA.WanD.C.PicardA.LavisJ.F.VazquezM.P.BeziatJ.L.Bilateral macrostomia as an isolated pathology. Cleft Palate Craniofac J. 2007; 44: 58–61.
8.
HikosakaM.NakajimaT.OgataH.MiyamotoJ.Refined simple line closure for macrostomia repair: designing a mucosal triangular flap on the commissure region. J Craniomaxillofac Surg. 2009; 37: 341–343.
9.
KawaiT.KuritaK.EchiverreN.V.NatsumeN.Modified technique in surgical correction of macrostomia. Int J Oral Maxillofac Surg. 1998; 27: 178–180.
10.
KawamotoH.K.Jr.The kaleidoscopic world of rare craniofacial clefts: order out of chaos (Tessier classification). Clin Plast Surg. 1976; 3: 529–572.
11.
KazanjianV.H.RoopenianA.The treatment of lip deformities resulting from electric burns. Am J Surg. 1954; 88: 884–890.
12.
KuriyamaM.UdagawaA.YoshimotoS.IchinoseM.SuzukiH.Tessier number 7 cleft with oblique clefts of bilateral soft palates and rare symmetric structure of zygomatic arch. J Plast Reconstr Aesthet Surg. 2008; 61: 447–450.
13.
LewinM.L.Congenital malformations of the ear and mandible. Oral Surg Oral Med Oral Pathol. 1950; 3: 1115–1120.
14.
MansfieldO.T.HerbertD.C.Unilateral transverse facial cleft - a method of surgical closure. Br J Plast Surg. 1972; 25: 29–32.
15.
MiyajimaK.NatsumeN.KawaiT.IizukaT.Oblique facial cleft, cleft palate, and supernumerary teeth secondary to amniotic bands. Cleft Palate Craniofac J. 1994; 31: 483–486.
16.
OnoI.TateshitaT.New surgical technique for macrostomia repair with two triangular flaps. Plast Reconstr Surg. 2000; 105: 688–694.
17.
OostromC.A.Vermeij-KeersC.GilbertP.M.van der MeulenJ.C.Median cleft of the lower lip and mandible: case reports, a new embryologic hypothesis, and subdivision. Plast Reconstr Surg. 1996; 97: 313–320.
18.
RogersG.F.MullikenJ.B.Repair of transverse facial cleft in hemifacial microsomia: long-term anthropometric evaluation of commissural symmetry. Plast Reconstr Surg. 2007; 120: 728–737.
19.
SowandeO.A.AnyanwuL.J.AdemuyiwaA.O.TalabiA.O.AdejuyiqbeO.Macrostomia: a report of three cases. Ann Plast Surg. 2011; 66: 354–356.
20.
StelnickiE.J.HoffmanW.FosterR.LopooJ.LongakerM.The in utero repair of Tessier number 7 lateral facial clefts created by amniotic band-like compression. J Craniofac Surg. 1998; 9: 557–562.
21.
StelnickiE.J.HoffmanW.Y.VanderwallK.HarrisonM.R.FosterR.LongakerM.T.A new in utero model for lateral facial clefts. J Craniofac Surg. 1997; 8: 460–465.
22.
TessierP.Anatomical classification of facial, craniofacial and laterofacial cleft. J Maxillofac Surg. 1976; 4: 69–92.
23.
TorkutA.CoskunfiratO.K.Double reversing Z-plasty for correction of transverse facial cleft. Plast Reconstr Surg. 1997; 99: 885–887.
24.
TrumppA.DepewM.J.RubensteinJ.L.BishopJ.M.MartinG.R.Cremediated gene inactivation demonstrates that FGF8 is required for cell survival and patterning of the first branchial arch. Genes Dev. 1999; 13: 3136–3148.
25.
Van der MeulenJ.C.Oblique facial clefts: pathology, etiology, and reconstruction. Plast Reconstr Surg. 1985; 76: 212–224.
26.
YenchaM.W.Congenital macrostomia. Otolaryngol Head Neck Surg. 2001; 124: 353–354.
27.
YoshimuraY.NakajimaT.NakanishiY.Simple line closure for macrostomia repair. Br J Plast Surg. 1992; 45: 604–605.
28.
YuC.C.GohR.C.LoL.J.ChenP.K.ChenY.R.Surgical repair for macrostomia: significance of Z-plasty limb directions. Ann Plast Surg. 2010; 64: 751–754.
