Tessier 30 Median Mandibular Hard and Soft Tissue Cleft, One-Stage Reconstruction Using a Template-Guided Resorbable “U”-Shaped Plate

Management of Tessier 30-Median Mandibular Cleft: 12-Year Follow-Up-A Case Report

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.

Tessier 30 Facial Clefts-A Literature Review of 72 Cases (1996-2020), Suggested Treatment Protocol, Outcome Measures, Minimum Dataset for Future Case Reports, and Registries

INTRODUCTION

Tessier 30 facial cleft is a rare anomaly presenting in the soft and hard tissues over the central lower face. Owing to the rarity of cases and difficulty of treatment, there is no universally accepted surgical management strategy. The last comprehensive literature review of Tessier 30 clefts was in 1996. This report aims to update the literature to inform decision-making on treating Tessier 30 cases.

METHODOLOGY

A literature search was performed. PubMed, SCOPUS, and OVID databases were searched. A total of 72 cases in 51 articles were analyzed, looking at demographics, extent of cleft, parent health, family history, procedures, follow-up, existence of other anomalies, and stages of repair.

RESULTS

Surgeons are increasingly choosing to repair Tessier 30 defects in one rather than multiple stages. Of the 72 cases studied, only 31 had documented the completed repair of the cleft. All completed soft tissue only defects were repaired in 1 stage of repair (n = 11). Where both soft tissue and mandible was involved (n = 20), 55% (n = 11) had undergone 1-stage repair to address the Tessier 30 cleft.

DISCUSSION

We argue that a single-stage approach is preferable to multistage. Primary mucogingivoperiosteoplasty should be undertaken in children at the time of management of the soft tissue cleft. The timing of this procedure should be in the latter half of the first year of life, as this is when mandibular symphyseal fusion normally occurs. We have suggested a treatment protocol and we hope that future case reports use our minimum data set.

Midline Mandibular Cleft Treatment

ABSTRACT

Tessier 30 cleft is a more rare anomaly comparing the other clefts and has variable clinical presentations. According to the literature, there were only 66 cases with Tessier 30 cleft reported since 2007. Furthermore, because of the rarity and variable clinical presentation of this condition, there is no consensus on the mode of management and timing of surgical procedures. In this case, we demonstrated the earlier treatment method of a newborn case with Tessier 30 cleft.

Clinical Correction of Complete Median Cleft of the Mandible and Lower Lip: A 17-Year Follow-Up of a Case Report With Literature Review

The median cleft of the mandible and lower lip is an extremely rare congenital maxillofacial deformity, and the therapeutic options are controversial. To evaluate the clinical characteristics and identify a better choice of treatment modes used among us and others, we reviewed 34 relevant literature and herein describe a 17-year follow-up of a case with a median cleft of the mandible and lower lip. Based on the literature and our case with good functional and aesthetical outcomes, we propose a prospective clinical treatment: Patients of Tessier 30 cleft associated with cleft of the mandible could undergo mandibular repair after puberty in conditions of a good occlusal relationship and normal maxillofacial development, even with mild masticatory dysfunction.