title: Surgical management and outcome of tessier number 10 clefts.
abstract: OBJECTIVE
  To present the clinical manifestations and outcome of the surgical management of subjects with Tessier number 10 clefts.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Twelve patients with Tessier number 10 clefts treated at the Department of Ophthalmology of Shanghai Ninth People's Hospital between January of 2002 and December of 2005.
  
  
  METHODS
  All 12 patients (15 eyes) underwent a standard ophthalmologic assessment, and the orbits were examined by a 3-dimensional computed tomography scan. Reconstructive techniques included eyebrow reconstruction with a frontal hairline transposition flap, eyelid reconstruction with a hard palate mucosa-lined sliding myocutaneous flap, and conjunctival fornix reconfiguration using a mucous membrane graft. In patients requiring enucleation, hydroxyapatite implant was used, followed by fitting of ocular prosthesis.
  
  
  METHODS
  Postoperative upper eyelid and eyebrow contour and viability, recurrence of symblepharon, and ability to hold prosthesis.
  
  
  RESULTS
  All reconstructed eyelids achieved the surgical goal of providing corneal coverage and the ability to hold a cosmetic contact lens or an ocular prosthesis. Eyebrow reconstruction was performed in 4 patients. The reconstructed eyebrow was symmetrical with the opposite side. There was no recurrence of symblepharon. Three patients wore cosmetic contact lenses, and their eyelid function appeared adequate. Two patients underwent enucleation along with insertion of a hydroxyapatite implant, followed by fitting of ocular prosthesis.
  
  
  CONCLUSIONS
  The surgical approach described in our series of cases seems to be effective in repairing Tessier number 10 clefts. Eyebrow reconstruction with a frontal hairline transposition flap followed by eyelid repair with a hard palate mucosa-lined sliding myocutaneous flap is a suitable technique for correcting eyebrow and eyelid malformations in adults.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China. fanxq@sh163.net
authors.forename: Xianqun
authors.initials: X
authors.lastname: Fan
authors.forename: Chunyi
authors.initials: C
authors.lastname: Shao
authors.forename: Yao
authors.initials: Y
authors.lastname: Fu
authors.forename: Huifang
authors.initials: H
authors.lastname: Zhou
authors.forename: Ming
authors.initials: M
authors.lastname: Lin
authors.forename: Huimin
authors.initials: H
authors.lastname: Zhu
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000145:classification / Q000601:surgery*; D005124:Eye Abnormalities / Q000601:surgery*; D005138:Eyebrows / Q000002:abnormalities*; D005143:Eyelids / Q000002:abnormalities*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult