tessier cleft

  • 文章类型: Journal Article
    在分娩室中检测到足月新生儿的罕见面部缺陷。缺陷是由于胎儿时期面部发育的畸形引起的。这种胚胎缺陷根据涉及的面部区域及其相关结构进行分类。
    A term newborn was detected for a rare facial defect in the delivery room. The defect arose due to malunion along the lines of facial development during fetal life. This embryonic defect is classified according to the areas of face involved and its associated structures.
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  • 文章类型: English Abstract
    眶上额叶裂是Tessier在1976年描述的罕见颅面裂之一,通常偶发。它们在这个分类中被编号为9、10和11,并分别位于横向,在轨道上部的中间和中间。它们的临床表现在软组织和骨骼上是可变的,与可能的参与分离。它们的范围从简单的美学缺陷到眼睛功能预后。在这种情况下,需要系统地进行CT扫描。他们的管理必须适应损害的多态性,并基于多学科方法。如果有眼部风险,眼睑重建是紧急情况。在所有其他情况下,治疗被推迟,但必须在早期进行,以确保孩子的健康发展。
    Superior orbital frontal clefts are one of the rare craniofacial clefts described by Tessier in 1976, and occur most often sporadically. They are numbered 9, 10 and 11 in this classification, and are located respectively laterally, in the middle and medially to the upper part of the orbit. Their clinical expression is variable on soft tissue and bone, with possible dissociation of involvement. They range from a simple aesthetic defect to an eyes functional prognosis. CT scans are systematically required in this context. Their management must be adapted to the polymorphism of the damage, and is based on multidisciplinary approach. In case of ocular risk, the eyelid reconstruction is an emergency. In all other cases, treatment is deferred, but must be carried out at an early stage to ensure the child\'s healthy development.
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  • 文章类型: Systematic Review
    Tessier裂隙是新生儿面部结构的骨骼和软组织异常。它们可以分为综合征性和非综合征性裂隙,这可以归因于胎儿发育中断和基因突变,分别。这些裂隙的报告病例通常证明存在与这些裂隙相关的其他异常。在这次系统审查中,我们分析了Tessier裂隙伴有心血管异常的报告,作为经常遇到的异常情况之一。我们系统地搜索了PubMed(MEDLINE),Scopus,WebofScience,科学直接,谷歌学者。我们选择并纳入病例报告,案例系列,以及Tessier裂隙和心血管异常患者的病例回顾。由两名独立研究人员使用基于共识的临床病例报告指南开发(CARE)清单对纳入的研究进行了严格评估。总的来说,20份报告(18份病例报告和2份病例系列报告)符合纳入本综述的条件。最常见的是Tessier裂隙3和30。此外,最常见的心血管异常包括室间隔缺损(VSD),右心室双出口,和房间隔缺损(ASD)。大多数患者接受了美容和心血管手术。然而,有些人由于病情不稳定而不适合心血管手术,因此无法生存。结论:在这些情况下,无论将重点放在裂口和随后的整形手术上,重要的是优先考虑其他可能与死亡率相关的异常.在面部美容手术之前,应进行完整的心血管系统和相关疾病评估。已知内容:•Tessier裂隙是面部软组织和骨骼的先天性缺陷,与许多其他先天性缺陷一样,它们伴随着身体其他部位的缺陷。•在当前的文献中,重点是裂缝和外观问题,而不是重合的缺陷,尤其是心血管异常.新增内容:•回顾Tessier裂隙患者常见的心血管异常。
    Tessier clefts are skeletal and soft tissue abnormalities of a neonate\'s facial structures. They could be classified as syndromic and non-syndromic clefts, which can be attributed to disruptions in fetal development and genetic mutations, respectively. Reported cases of these clefts typically document the presence of additional abnormalities associated with these clefts. In this systematic review, we analyzed reports of Tessier clefts accompanied by cardiovascular anomalies, as one of the commonly encountered anomalies. We systematically searched PubMed (MEDLINE), Scopus, Web of Science, Science Direct, and Google Scholar. We selected and included case reports, case series, and case reviews on patients with Tessier cleft and cardiovascular anomalies. The critical appraisal of the included studies was performed by two independent investigators using the Consensus-based Clinical Case Reporting Guideline Development (CARE) checklist. Overall, 20 reports (18 case reports and 2 case series) were eligible for inclusion in this review. Tessier clefts 3 and 30 were the most commonly observed. In addition, the most prevalent cardiovascular anomalies consisted of the ventricular septal defect (VSD), double-outlet right ventricle, and atrial septal defect (ASD). Most of the patients received cosmetic and cardiovascular surgeries. However, some were not proper candidates for cardiovascular surgery because of their unstable condition and therefore did not survive.   Conclusion: Regardless of the focus placed on the cleft and subsequent plastic surgery procedures in these cases, it is important to prioritize other abnormalities that may be associated with mortality. A complete cardiovascular system and associated disorders assessment should be performed before facial cosmetic surgeries. What is Known: • Tessier clefts are congenital defects in the soft tissues and bones of the face and like many other congenital defects, they are accompanied by defects in other parts of the body. • In the current literature, the emphasis is on clefts and the cosmetic issues rather than the coinciding defects, particularly cardiovascular anomalies. What is New: • Review the cardiovascular anomalies that are commonly encountered in patients with Tessier clefts.
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  • 文章类型: Case Reports
    紧急产科分娩可能会给麻醉师带来独特的挑战,即在产科手术室中管理先前未诊断的综合征或畸形新生儿的气道。本报告描述了一名32岁女士的紧急剖腹产,该女士分娩了一个具有严重异常特征的新生儿,新生儿气道管理的挑战,以及关于麻醉医生和相关医疗团队遇到这种情况的准备和敏感性的讨论。
    Emergent obstetric deliveries may present the anesthesiologist with a unique challenge of managing the airway of previously undiagnosed syndromic or malformed newborns in the obstetric theatre. The present report describes an emergency cesarean section in a 32-year-old lady who delivered a newborn with grossly anomalous features, the challenges in airway management in the newborn, and a discussion on preparation and sensitization about encountering such scenarios for the anesthesiologist and the associated medical teams.
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  • 文章类型: Case Reports
    下颌骨和下唇中线裂是罕见的先天性面部畸形。下颌骨联合骨不连,下唇的正中裂口和舌头在中线粘附到口底是异常的主要特征。对硬组织和软组织缺损的早期手术矫正可产生出色的功能,例如咀嚼和言语。12年的随访显示,根据患者的实际年龄,联合骨完全融合和下颌骨的正常生长。
    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.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Case Reports
    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.
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  • 文章类型: Journal Article
    BACKGROUND: Craniofacial clefts belong to the most disfiguring and rare congenital malformations of the face and among these, orbito-facial clefts constitute approximately 0.22 % of the cases with Tessier cleft number 5 being the least common. Our aim was to define the phenotypic spectrum for this subgroup to improve clinical management.
    METHODS: Our study group consisted of four patients which were treated at two different cleft centers. Retrospective chart review and anatomical analysis were conducted for each patient based on clinical evaluation and imaging studies. Morphological anomalies including soft tissue, bone and oral components were recorded.
    RESULTS: Based on our analysis and literature review, we could define two subtypes of Tessier facial cleft number 5. (1) Medial clefts are the more severe subtype, creating a significant soft tissue and bone defect that runs vertically, through the eyelid, infraorbital rim, maxillary sinus and cheek. They have the poorer esthetic and functional prognosis, due to orbital dystopia and absence of lower eyelid. (2) Lateral clefts are a less severe subtype characterized by the presence of a vertical furrow of the cheek running laterally to the maxillary sinus.
    CONCLUSIONS: We identified two subtypes of facial cleft number 5 which require an individualized surgical management.
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  • 文章类型: Journal Article
    Tessier\'s classification system for rare craniofacial clefts remains the most widely used today. It denotes the position of the cleft process in a schema based around the orbit, and facilitates communication between surgeons regarding these complicated conditions. Tessier\'s classification is reviewed in detail, and a separate discussion of hypertelorism (increased distance between the bony orbits) follows, focusing on orbital hypertelorism in the setting of craniofacial clefts.
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  • 文章类型: Journal Article
    BACKGROUND: Repair of facial clefts implies wide tissue mobilization with multi-stage surgical treatment. Authors propose pre-surgical orthopedic correction for naso-oro-ocular clefts and a novel surgical option for Tessier No. 3 cleft.
    METHODS: Two male infants, a Tessier No. 3 cleft (age 7 months) and another Tessier No. 4 (age 3 months), were treated with a modified orthopedic Latham device with additional septo-premaxillary molding and observed to age four years. Tessier No. 3 orthopedic measurements were obtained by image corrected cephalometric analysis. Subsequent repair included tissue expansion on Tessier No. 4 and naso-frontal Rieger flap combined with myocutaneous upper lid flap on Tessier No. 3.
    RESULTS: Orthopedic movements ranged from 18.5 mm in bi-planar to 33 mm in oblique analyses. Tissue margins became aligned with platform normalization. Tissue expansion on Tessier No. 4 improved distances from ala base-lower lid and subalar base-lip. The naso-frontal flap combined with myocutaneous upper lid flap on Tessier No. 3 had similar achievement, but also sufficiently lengthened ala base-canthal distance.
    CONCLUSIONS: Repairs were facilitated by pre-surgical orthopedic correction. The naso-frontal flap combined with an upper lid myocutaneous flap seems viable as a single-stage option to lengthen ala base-canthal distance to advance repair achievement in unilateral Tessier No. 3.
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