Options for the nasal repair of non-syndromic unilateral Tessier no. 2 and 3 facial clefts

Abstract

Background:Non-syndromic Tessier no. 2 and 3 facial clefts primarily affect the nasal complex. The anatomy of such clefts is such that the ala of the nose has a cleft. Repairing the ala presents some challenges to the surgeon, especially to correct the shape and missing tissue. Various techniques have been considered to repair these cleft defects.Aim:We present two surgical options to repair such facial clefts.Materials and Methods:A nasal dorsum rotational flap was used to treat patients with Tessier no. 2 clefts. This is a local flap that uses tissue from the dorsal surface of the nose. The advantage of this flap design is that it helps move the displaced ala of a Tessier no. 2 cleft into its normal position. A forehead-eyelid-nasal transposition flap design was used to treat patients with Tessier no. 3 clefts. This flap design includes three prongs that are rotated downward. A forehead flap is rotated into the area above the eyelid, the flap from above the eyelid is rotated to infra-orbital area and the flap from the infraorbital area that includes the free nasal ala of the cleft is rotated into place.Results and Conclusions:These two flap designs show good results and can be used to augment the treatment options for repairing Tessier no. 2 and 3 facial clefts.

A Rare Case of a Combination of Tessier Cleft 0 and 3 in a 4-Year-Old Child—A Case Report

“…A combination of Tessier cleft 0 and 3 is rare. The procedures mentioned are the nasolabial flap, 3 4 forehead flap, and alar transposition flap. 5 6 These lead to visible scars.…”