Classification of oblique facial clefts with microphthalmia.
We believe the Tessier classification system facilitates the description of complicated facial clefts, and we describe its use in 4 cases--all of whom had variations of a Tessier-3 cleft. Microphthalmia is associated with the Tessier-3 cleft. Computerized axial tomography may be helpful in differentiating an extreme microphthalmia from a true anophthalmia, and in detecting bony clefts not seen on roentgenographic studies. Facial tomograms show that abnormalities of the medial wall of the orbit in the Tessier-3 cleft vary from actual clefts to widening of the ethmoid. In our experience (with 4 patients) mental retardation does not necessarily occur in patients with the Tessier-3 cleft and extreme microphthalmia. Abnormalities of the nasolacrimal apparatus may be the most constant finding in patients with the Tessier-3 cleft. Children with the Tessier-3 cleft should be identified early for purposes of determining the proper treatment and valid genetic counseling.
D000853:Anophthalmos / Q000000981:diagnostic imaging; D002971:Cleft Lip / Q000145:classification / Q000601:surgery; D002972:Cleft Palate / Q000145:classification / Q000601:surgery; D003937:Diagnosis, Differential; D005145:Face / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008850:Microphthalmos / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D009301:Nasolacrimal Duct / Q000002:abnormalities; D009915:Orbit / Q000002:abnormalities / Q000000981:diagnostic imaging; D013518:Surgery, Plastic; D013577:Syndrome; D014057:Tomography, X-Ray Computed