title: Early bone grafting in Tessier number 4 cleft: a case report.
abstract: Rare craniofacial clefts have an incidence of at least 1 per 100,000 live births. A Tessier number 4 cleft is one of the most rare craniofacial clefts, with less than 50 cases being reported in the literature. Both soft and bony tissue abnormalities take place in the cleft morphology, so not only clinical examination of the maxillofacial region but a detailed radiological workup is needed to assess clearly the nature of the clefts. A patient with a Tessier number 4 cleft is presented, whose bony defect was obliterated with autogenous iliac bone graft chips and soft tissue reconstruction was performed with multiple Z-plasty flaps. Postoperative clinical and radiological results demonstrate fine healing and good cosmesis. Although controversy still exists about the treatment of facial clefts with early bone grafts, advantages of performing both bony and soft tissue reconstructions in a single session make this treatment a good alternative with satisfactory clinical and radiological results.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical Faculty, Gazi University, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Sari
authors.forename: Reha
authors.initials: R
authors.lastname: Yavuzer
authors.forename: Selahattin
authors.initials: S
authors.lastname: Ozmen
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuncer
authors.forename: Osman
authors.initials: O
authors.lastname: Latifoglu
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000637:transplantation*; D016025:Bone Transplantation / Q000379:methods; D002971:Cleft Lip / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D003724:Dental Arch / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005143:Eyelids / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000637:transplantation; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome