title: A surgical conundrum: Tessier number 4 cleft.
abstract: 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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical Faculty, Erciyes University, Kayseri, Turkey. atilla.coruh@superonline.com
authors.forename: Atilla
authors.initials: A
authors.lastname: Coruh
authors.forename: Galip K
authors.initials: GK
authors.lastname: Gunay
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps