Midline clefts of mandible and lower lip are rare congenital facial deformities. Non-union of bone in the symphysis of the mandible, median cleft of the lower lip and tongue adherence in the midline to the floor of the mouth are the principle features of the anomaly. Early surgical correction of both hard and soft tissue defects resulted in excellent function such as mastication and speech. 12-yr follow-up shows total bony fusion of the symphysis and normal growth of mandible as per the chronologic age of patient.

The authors present findings and techniques to address hemipalatal discrepancy in patients with Tessier 7 cleft and associated cleft palate during cleft palatoplasty.
The authors report 2 cases of pediatric patients with Tessier 7 facial clefts and associated cleft palate. One patient presents on the broader oculo-auriculo-vertebral spectrum and the other is has isolated Tessier cleft 7. Additionally, a PubMed search was performed using the MeSH terms \"tessier 7,\" \"cleft palate\", \"macrostomia,\" \"tessier 7 AND cleft palate,\" \"macrostomia AND cleft palate,\" AND \"hemipalatal discrepancy.\" All relevant literature was identified and underwent full review for qualitative analysis.
Two patients met criteria for inclusion in this article. The surgical techniques utilized to mitigate the hemipalatal length discrepancy are detailed, and intraoperative photographs are provided. The results of the literature review are also presented. Tessier 7 craniofacial cleft and palatal clefts, when occurring in combination, is noted to result in discrepant hemipalatal length with short maxillary palate length on the affected side as well hypoplasia of the associated speech musculature. The postoperative palatal length after palatoplasty in both patients was longer than the preoperative hypoplastic palatal length.
When occurring in combination, Tessier 7 craniofacial cleft and concomitant palatal cleft results in discrepant hemipalatal length, and deficiency of the bony maxillary palatal shelves, and associated speech musculature and soft tissues. The techniques described in this article may assist in maximizing postoperative palatal length.

Tessier 7 clefts are a rare congenital anomaly, usually surgically repaired with Z-plasty or other reconstructive methods, although undesirable scars may result. We present a review of the literature and a case of unilateral Tessier 7 cleft repaired with a novel reconstruction technique using a combined Z-plasty and geometric broken line closure (GBLC) to camouflage and irregularize the otherwise linear scar. We present this case to expand the armamentarium of surgical options to address Tessier 7 clefts and to review techniques for repair.

Oblique facial clefts are rare congenital anomalies that can present alone or in association with other craniofacial anomalies. A high degree of clefting in the embryo may lead to hyperdontia secondary to dichotomy of the dental lamina. Multiple facial clefts with hyperdontia are clinically challenging and demand comprehensive rehabilitation. This article reports a case of multiple oblique facial clefts of variable severity with multiple supernumerary teeth in a 12-year-old boy. The varied clinical presentation along with the rarity of the occurrence mandate documentation.