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Median cleft deformities of the lower lip and mandible are very rare congenital anomalies. Our patient had median cleft of the lower lip, mandible, and the chin with tongue duplication, ankyloglossia, and cleft strap muscles with 2 neck contracture bands. This anomaly was associated with congenital heart disease transposition of great vessels, large ventricular septal defect, and severe pulmonary stenosis. Early repair was done at 6 months to improve feeding.

Background: Basal cell carcinoma (BCC) represents the most common type of facial skin cancer in Middle East and Egypt. It rarely metastasizes, but because of its locally destructive nature, it can cause high morbidity. Reconstruction by local flap after surgical excision depends on the size of the defect and the affected facial aesthetic unit.Aim: To reveal the prevalence of facial BCC, relation of its site to facial aesthetic units and type of local flaps used for reconstruction per units. Patients and Methods:A retrospective study was conducted on 80 patients with facial BCC that admitted to the outpatient clinic, Plastic Surgery Department, Qena University Hospital from June 2018 to May 2020 (2 years duration). Only earlystage and primary tumors were included. Statistical analysis: Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 24. A p-value <0.05 was considered significant.Results: 80 patients with facial basal cell carcinoma (BCC) were collected from medical records. 45 (56.25%) patients were males and 35 (43.75%) patients were females (M:F = 1.3:1). Ages ranged from 52-78 years old (SD = 65±13). Nodular subtype was the most common clinical type of BCC and presented in 45 (56.25%) patients. Nasal unit was the most common site in 18 (22.5%) patients. The most random flap applied was the rhomboid (Limberg) flap in 15 cases. The most axial flap used was the nasolabial flap in 9 cases. Complications (6 cases, 7.5%) included: Wound dehiscence in 3 cases, infection in 2 cases and skin slough in 1 case. The SCAR scale score result ranged from 0-2 score. Conclusion:Facial defects reconstruction after surgery for basal cell carcinoma is a complex endeavor that requires careful consideration. There are many different local flaps available depending on the particular facial subunit that requires reconstruction. Careful recognition of the principles of the facial subunits will equip the surgeon to achieve the best possible functional and aesthetic outcomes.

Background: Zygomatic complex and arch fractures remain one of the most common maxillofacial fractures. Epidemiological studies of theses fractures vary by geographic region, socioeconomic, environmental and cultural factors. Its importance is confirmed by their implication in the clinical practice and prevention.Patients and Methods: Five-year retrospective study; from May 2015 to April 2020; was conducted on 120 patients with zygomatic fractures in our department. Fracture sites were classified into five types (I-V) based on the number of fractured processes and comminution. Data collected in a clinical sheet and analyzed using Statistical Package for Social Sciences version 20. p-value <0.05 was considered significant. Chi square test was used to compare between 2 or more qualitative variables.Results: Patients aged from 15-78 years old and divided into 4 age groups (A-D). Group B (21-40 years) was the commonest affected. Males were predominant than females with ratio M: F = (7:1). Motor car accidents was the commonest etiology of trauma (56.60%). Left sided fracture (52.5%) was involved more than right sided one (45%) and fracture was bilateral in 2.5% of cases. Type-IV fracture (classic tetrapod) was the commonest type reported (42 cases, 35%). Most common fractured process was zygomatic-maxillary buttress (ZM) in 90 cases (75%). Mandibular fracture (15%) was the most common associated facial fractures. Most common accessed approach was the upper buccal in 80 cases (66.6%). Access through a preexisting wound was encountered in 10 cases (8.3%). Four-point fixation (40%) was the commonest point fixation for these fractures. Infra orbital paresthesia (42 cases) was the most common complications encountered. Conclusion:Zygomatic fractures have high morbidity and cost of life. Use of protective devices, strict laws and severe punishments must be implemented to reduce its frequency.

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