Congenital Clefts of the Nose: Principles of Surgical Management

Abstract

Congenital clefts of the nose are rare and highly variable. Because there are few examples, standard methods for treatment do not exist. Therefore each patient must be evaluated and managed individually with respect to anatomic elements, timing, and sequence of reconstruction.

Tessier 3 cleft with bilateral anophthalmia: Case report and surgical treatment

“…The surgical management of rare craniofacial clefts is a challenge, given the small number of techniques published, the lack of standardized guidelines, and the variability in clinical presentation (Tessier, 1969a,b;Tessier et al, 1977;Van der Meulen, 1985;Van der Meulen and Vaandrager, 1989;Shewmake and Kawamoto, 1992;Mishira and Purwar, 2009;Laure et al, 2010;da Silva Freitas et al, 2010;Bütow and Botha, 2010;Hou et al, 2011). We report a very severe Tessier 3 cleft with bilateral microphthalmia.…”

A chronicle of Tessier no. 0 and 1 facial cleft and its surgical management

“…When managed successfully such patients become beautiful feathers in the cap of our surgical careers. Initial attempts to describe the rare facial clefts were done by Davis [4], Blackfield and Wilde [3], Fogh-Anderson [5], Popescu [15], Pitanguy [14] and more recently by Shewmake and Kawamoto [16]. Numerous attempts have been made to classify the facial clefts.…”

“…Shewmake [16] and Kawamoto [9] have nicely elucidated the principles of management of cleft nose. They have concluded that each nasal cleft is unique and should be completely evaluated to determine the specific degree of anatomic pathology.…”

Craniofacial clefts

“…However, certain general treatment principles apply as a foundation for each individual treatment plan: 21,22,[24][25][26] • manage functional problems early; Psychological aspects also play a role.…”