title: Atypical midline cleft with duplication of the metopic suture.
abstract: BACKGROUND
  In contrast to the common clefts of the lip, alveolus and palate, the atypical clefts of the face may come in myriad patterns of clinical expression and are often not easy to define.
  
  
  OBJECTIVE
  In this report, a case of median craniofacial dysraphia is described.
  
  
  METHODS
  At presentation, the 3-month-old male patient had a bilateral complete cleft of the lip, alveolus and palate. The nose was wide and a horn was present on the nasal dorsum. 3-D CT AND MRI REVEALED: Duplication of the metopic suture ending at the wide anterior fontanel; orbital hypertelorism; midline cranial cleft ending just superior to the nasal dorsum; frontoethmoidal encephalocoele and holoprosencephaly. The presence of two metopic sutures was confirmed during surgery.
  
  
  CONCLUSIONS
  The presented case carries the characteristics of the median cleft face syndrome. However, it differs from similar cases in two respects. First, the patient had two metopic sutures, one on either side of the cranial extension of the median cleft. Second, the patient had a bilateral cleft lip in contrast to the expected median cleft lip deformity.
authors: Department of Plastic & Reconstructive Surgery, Marmara University, University Hospital.,Istanbul, Turkey.
authors: Ozhan
authors: O
authors: Celebiler
authors: Ahmet
authors: A
authors: Sönmez
authors: Melike
authors: M
authors: Erdim
authors: Memet
authors: M
authors: Ozek
authors: Ayhan
authors: A
authors: Numanoğlu
mesh_terms: D002531:Cerebellum / Q000002:abnormalities / Q000601:surgery; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003393:Cranial Sutures / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004677:Encephalocele / Q000601:surgery; D016142:Holoprosencephaly / Q000601:surgery; D006801:Humans; D006972:Hypertelorism / Q000000981:diagnostic imaging / Q000473:pathology; D007223:Infant; D008297:Male; D009128:Muscle Spasticity / Q000151:congenital; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D011859:Radiography; D013577:Syndrome