Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see Bilateral macrostomia, muscle repair, straight line closure. Congenital macrostomia is a relatively rare deformity. A number of different methods for its correction have been reported in the past. Here, we report our refined. Congenital macrostomia (transverse facial cleft) is a relatively rare anomaly. Surgical methods used to correct this anomaly include commissuroplasty.
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Cleft Palate Craniofac J ; The remaining parameters such as occlusion and temporomandibular joint functions are normal. Indexed in Web of Science.
The point of new commissure must be predetermined with accuracy and preoperative markings of the normal landmarks are very important.
Straight line closure for correction of congenital isolated bilateral macrostomia
Transverse facial or Tessier No. Anatomical considerations in the repair of macrostomia. In this paper, we present a six-year-old girl with unilateral macrostomia with preauricular skin tags and malformation of pinna on ipsilateral side treated with vermillion-square flap method.
The skin is closed with small Z-plasty as the maceostomia is minimal and the limbs of Z-plasty also aligned satisfactorily into the nasolabial and mentolabial folds giving satisfactory healing.
Transverse facial cleft is a rare congenital anomaly with only 21 cases reported in the world literature. In most of the series in the literature transverse cleft accounts for less than 0.
Case Reports mxcrostomia Dentistry. An interruption of orbicularis oris muscle results in compromised sphincteric function and facial expression. Reference points from the noncleft side are marked and transposed those into the cleft side to achieve symmetry.
Problems associated with macrostomia include aesthetic disharmony and functional problems like feeding difficulties, drooling, speech incoherence, and difficulty in blowing. References Publications referenced by this paper. The goal of surgical correction of these clefts includes good aesthetics and better function of orbicularis oris muscle. Although the creation of a symmetric neocommissure is imperative, this presents a technical challenge.
Haematological investigations are within normal limits. Double reversing Z-plasty for correction of transverse facial cleft.
Repair for Congenital Macrostomia: Vermilion Square Flap Method
Abstract Transverse facial clefts macrostomia are rare disorders that result when the embryonic mandibular and maxillary processes of the first branchial arch fail to fuse due to failure of mesodermal migration and merging to obliterate the embryonic grooves between the maxillary and mandibular processes to form the angle of the mouth at its normal anatomic position.
The severity of these clefts also differs. Both the points coincided, and the entire surgical correction was centered on these points.
After a thorough evaluation to rule out any associated anomalies, the child was scheduled for surgical correction. Straight line closure of congenital macrostomia.
Modified technique in surgical correction of macrostomia. Natural contour of the oral commissure is obtained both at rest and during movement. Transverse facial clefts are more common in males and more common on the left side when reoair.
The optimal length of a medial small triangular flap is 1. The extent of clefting in the muscle ranges from mild which is confined to the orbicularis oris to the buccinator macrosyomia even extends backwards to the repiar muscle. We report a case of macrostomia corrected with Z-plasty closure for skin, overlapping muscle closure, and triangular mucosal flap for commissure, with a review on existing techniques. Evaluation was based on the degree of symmetry of the lips as a ratio of the affected side to the unaffected side, and the scar characteristics.
The skin, muscle, and mucosal components of the deformity were separately repaired using a modification of Kaplan’s technique. The vermilion square flap on the lower lip was elevated. Triangular mucosal flaps will result in a natural looking maceostomia and can avoid transposition of the skin.
It is believed that the superficial component functions during facial expression and provides the precise movements of the lips necessary for complex speech production.
See all authors and affiliations. The aesthetic outcome of these surgeries depends not only on the placement of scars along the natural skin creases but also on their showup during facial expressions.
Indian J Plast Surg ; However, the choice of technique should be based on the subclassification of defect in order to disguise the scar in the natural skin lines. Gorlin believes that the lateral facial clefts are postmerging tears as there is considerable clinical variation [ 3 ].
Abstract Macrostomia is a congenital deformity resulting from failure of marostomia of maxillary and macrostomi process.