title: The Tessier number 3 cleft: a report of 10 cases and review of literature.
abstract: The Tessier number 3 cleft is one of the most intricate and destructive of all facial clefts, presenting surgeons with a difficult task for reconstruction. We present a series of 10 patients with this rare cleft all treated by a single surgeon over 30 years. All patients with Tessier number 3 clefts treated between 1978 and 2008 by the senior surgeon were reviewed. Demographic data and all associated clinical findings including cranial and extracranial anomalies were recorded. Methods used to reconstruct each patient were also noted. Seven males and three females were identified and age at initial treatment ranged from 12 months to 12 years. Mean follow-up was 6.3 years. Multiple craniofacial anomalies were appreciated including other rare facial clefts, hypertelorbitism, lacrimal obstruction, anophthalmia, choanal atresia, and hemifacial microsomia. Amniotic banding was the most prominent extracranial finding noted in these patients. Tessier number 3 clefts can be associated with multiple other craniofacial anomalies making reconstruction challenging. Soft tissue and bony reconstruction must be considered separately, and a variety of tools may be employed to accomplish each goal. As the presentation can be highly variable, an individualized treatment plan must be made to meet each patient's specific needs.
authors.affiliation: Sohag Cleft-Craniofacial Unit, Plastic Surgery Department, Sohag University, University Street, Sohag 82524, Egypt. Electronic address: allamkaram@yahoo.com.
authors.forename: Karam A
authors.initials: KA
authors.lastname: Allam
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California Los Angeles Medical Center, 200 Medical Plaza, Suite 465, Los Angeles, CA 90024, USA.
authors.forename: Alan A
authors.initials: AA
authors.lastname: Lim
authors.affiliation: Sohag Cleft-Craniofacial Unit, Plastic Surgery Department, Sohag University, University Street, Sohag 82524, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elsherbiny
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California Los Angeles Medical Center, 200 Medical Plaza, Suite 465, Los Angeles, CA 90024, USA.
authors.forename: Henry K
authors.initials: HK
authors.lastname: Kawamoto
mesh_terms: D000015:Abnormalities, Multiple / Q000145:classification / Q000601:surgery; D000293:Adolescent; D000652:Amniotic Band Syndrome / Q000150:complications; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000145:classification* / Q000601:surgery*; D005145:Face / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009056:Mouth Abnormalities / Q000150:complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult
keywords: Number 3 cleft; Rare facial cleft; Surgical reconstruction; Tessier cleft