+44 151 808 1136A rare case of Tessier number 7 unilateral cleft: Macrostomia, left with accessory tragus, bilateral presenting in a nine-year-old Filipino female patient: A case report
10th International Conference on Otolarngology: ENT Surgery
May 15, 2023 | Webinar
Jann Louie Tan
Vicente Sotto Memorial Medical Center, Philippines
Keynote : Otolaryngology Online Journal
Abstract:
Tessier Number 7 Cleft also known as Transverse Facial Cleft or Congenital Macrostomia is a rare congenital anomaly with an incidence of 1 in 60,000 births to 1 in 300,000 live births. It is caused by the migration failure of the mesodermal process after the fusing of the embryonic grooves between the maxillary and mandibular prominences of the first branchial arch during the fourth and fifth week of the embryonic life. Presentation of this condition varies from a slight widening of oral commissure to a cleft extending to the tragus of the ear and hemifacial microsomia. Macrostomia presents both aesthetic and functional problems, such as oral incompetence and difficulties in facial expression, mastication, and speech. These are the factors that should be considered during reconstruction. However, psychosocial factor is also an important aspect in dealing with these types of defects. Surgery is the treatment of choice, wherein the goal is the proper repair of the orbitalis oris muscle for restoration of oral function, forming a symmetric and aesthetically pleasing oral commissure with a minimally visible scar. In this report, we present a 9-year-old female with intermittent drooling due to a facial deformity. She was diagnosed with Congenital Macrostomia and Bilateral Accessory Tragus and eventually underwent repair via Vermillion Return Flap Technique. There are multiple types of repairs for this condition, however, other techniques tend to have visible scars due to the pattern and a sharp oral commissure. In this case, the choice of this technique is mainly to avoid the complications mentioned above. Post-operatively, the patient had a good oral sphincter function, facial and lip movements were preserved, was able to grin/smile, and was aesthetically pleasing to both the scar and the oral commissure. It was also reported that the patient had renewed self-confidence, especially in her school performance.
Biography:
Jann Louie Tan has completed his medical school at the University of the Visayas – Gullas College of Medicine took his Post Graduate Internship at Chong Hua Hospital in Cebu and is currently a Senior ORL-HNS Resident in Vicente Sotto Memorial Medical Center in Cebu, Philippines. He was able to present this case during the 11th International Conference of Pan Asia Academy of Facial Plastic and Reconstructive Surgery in Singapore last February 22, 2023.
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