CC BY-NC-ND 4.0 · Indian J Plast Surg 2014; 47(03): 340-345
DOI: 10.4103/0970-0358.146588
Original Article
Association of Plastic Surgeons of India

Options for the nasal repair of non-syndromic unilateral Tessier no. 2 and 3 facial clefts

Srinivas Gosla Reddy
1   GSR Institute of Craniofacial Surgery, Hyderabad, Telangana, India
,
Rajgopal R. Reddy
1   GSR Institute of Craniofacial Surgery, Hyderabad, Telangana, India
,
Joachim Obwegeser
2   Children Hospital Zurich, University Zurich, Zurich, Switzerland
,
Maurice Y. Mommaerts
3   Bruges Cleft and Craniofacial Centre, GH St. Jan, Bruges, Belgium
› Author Affiliations
Further Information

Address for correspondence:

Dr. Srinivas Gosla Reddy
GSR Institute of Craniofacial Surgery,
17-1-383/55, Vinaynagar Colony, I.S. Sadan, Saidabad, Hyderabad - 500 059, Andhra Pradesh
India   

Publication History

Publication Date:
26 August 2019 (online)

 

ABSTRACT

Background: Non-syndromic Tessier no. 2 and 3 facial clefts primarily affect the nasal complex. The anatomy of such clefts is such that the ala of the nose has a cleft. Repairing the ala presents some challenges to the surgeon, especially to correct the shape and missing tissue. Various techniques have been considered to repair these cleft defects. Aim: We present two surgical options to repair such facial clefts. Materials and Methods: A nasal dorsum rotational flap was used to treat patients with Tessier no. 2 clefts. This is a local flap that uses tissue from the dorsal surface of the nose. The advantage of this flap design is that it helps move the displaced ala of a Tessier no. 2 cleft into its normal position. A forehead-eyelid-nasal transposition flap design was used to treat patients with Tessier no. 3 clefts. This flap design includes three prongs that are rotated downward. A forehead flap is rotated into the area above the eyelid, the flap from above the eyelid is rotated to infra-orbital area and the flap from the infraorbital area that includes the free nasal ala of the cleft is rotated into place. Results and Conclusions: These two flap designs show good results and can be used to augment the treatment options for repairing Tessier no. 2 and 3 facial clefts.


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Conflict of Interest

None declared.

  • REFERENCES

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  • 3 Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 1976; 4: 69-92
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  • 14 Ortega J, Flor E. Incomplete naso-ocular cleft Case report. Plast Reconstr Surg 1969; 43: 630-6
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Address for correspondence:

Dr. Srinivas Gosla Reddy
GSR Institute of Craniofacial Surgery,
17-1-383/55, Vinaynagar Colony, I.S. Sadan, Saidabad, Hyderabad - 500 059, Andhra Pradesh
India   

  • REFERENCES

  • 1 Zhou YQ, Ji J, Mu XZ, Zhang RH, Wei M, Yu ZY. Diagnosis and classification of congenital craniofacial cleft deformities. J Craniofac Surg 2006; 17: 198-201
  • 2 Ortiz Monasterio F, Fuente del Campo A, Dimopulos A. Nasal clefts. Ann Plast Surg 1987; 18: 377-97
  • 3 Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 1976; 4: 69-92
  • 4 Fearon JA. Rare craniofacial clefts: A surgical classification. J Craniofac Surg 2008; 19: 110-2
  • 5 Ozek C, Gundogan H, Bilkay U, Cankayali R, Guner U, Gurler T. et al. Rare craniofacial anomaly: Tessier no 2 cleft. J Craniofac Surg 2001; 12: 355-61
  • 6 Wenbin Z, Hanjiang W, Xiaoli C, Zhonglin L. Tessier 3 cleft with clinical anophthalmia: Two case reports and a review of the literature. Cleft Palate Craniofac J 2007; 44: 102-5
  • 7 Schweckendiek W. Nasal abnormalities in facial clefts. J Maxillofac Surg 1976; 4: 141-9
  • 8 Kawamoto HK, David DJ. Rare craniofacial clefts. In: McCarthy JC. editor Plastic surgery. Vol. 4. Philadelphia: W. B. Saunders; 1990: p. 2922-73
  • 9 Mishra RK, Purwar R. Formatting the surgical management of Tessier cleft types 3 and 4. Indian J Plast Surg 2009; 42 Suppl S174-83
  • 10 Bilen BT, Kilinç H. A congenital isolated alar cleft. J Craniofac Surg 2006; 17: 602-4
  • 11 Rashid M, Islam MZ, Tamimy MS, Haq EU, Aman S, Aslam A. Rotation-transposition correction of nasal deformity in Tessier number 1 and 2 clefts. Cleft Palate Craniofac J 2009; 46: 674-80
  • 12 Jinka JR, Chekuri H, Annavarapu G. Isolated cleft of the ala nasi: A report of seven cases. Indian J Plast Surg 2012; 45: 512-5
  • 13 Madaree A, Morris WM, McGibbon IC. A method of repairing the no 3 facial cleft. Br J Plast Surg 1992; 45: 44-6
  • 14 Ortega J, Flor E. Incomplete naso-ocular cleft Case report. Plast Reconstr Surg 1969; 43: 630-6
  • 15 Fazio MJ, Zitelli JA. The single stage nasolabial flap. Oper Tech Plast Reconstr Surg 1998; 5: 50-8
  • 16 Dupuis A, Hainsdorf F. Treatment of nasal saddle-back deformities using a median naso-frontal five-point star flap. Rev Stomatol Chir Maxillofac 1983; 84: 289-93