2007 Volume 53 Issue 10 Pages 603-607
Oblique facial cleft is an extremely rare congenital anomaly, corresponding to No.3, 4, and 5 clefts according to Tessier's classification. Little is published about the treatment of No.5 clefts because of the rare nature of this anomaly.
We report a case of bilateral oblique facial clefts, classified as a No.5 cleft on the left side and a No.4 cleft on the right side. We first saw the patient in Mexico during the charity surgical mission of the Japan International Cooperation Agency (JICA). Primary plastic surgery for the right-side cleft was performed at 8 months of age in Mexico; however, there was little aesthetic or functional inprovement. Therefore, surgical treatment was performed in Japan as a part of JICA's mission at the request of the Mexican treatment team.
At 14 months of age, bilateral plastic surgery was performed, using multiple small triangular flaps for the No.4 cleft, and modified commissuroplasty for the No.5 cleft. This operation procedure, especially that for the No.5 cleft, greatly improved facial appearance and function.