Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep-Dec;47(3):340-5.
doi: 10.4103/0970-0358.146588.

Options for the nasal repair of non-syndromic unilateral Tessier no. 2 and 3 facial clefts

Srinivas Gosla Reddy  1 , Rajgopal R Reddy  1 , Joachim Obwegeser  2 , Maurice Y Mommaerts  3
Affiliations

Options for the nasal repair of non-syndromic unilateral Tessier no. 2 and 3 facial clefts

Srinivas Gosla Reddy et al. Indian J Plast Surg. 2014 Sep-Dec.

Abstract

Background: Non-syndromic Tessier no. 2 and 3 facial clefts primarily affect the nasal complex. The anatomy of such clefts is such that the ala of the nose has a cleft. Repairing the ala presents some challenges to the surgeon, especially to correct the shape and missing tissue. Various techniques have been considered to repair these cleft defects.

Aim: We present two surgical options to repair such facial clefts.

Materials and methods: A nasal dorsum rotational flap was used to treat patients with Tessier no. 2 clefts. This is a local flap that uses tissue from the dorsal surface of the nose. The advantage of this flap design is that it helps move the displaced ala of a Tessier no. 2 cleft into its normal position. A forehead-eyelid-nasal transposition flap design was used to treat patients with Tessier no. 3 clefts. This flap design includes three prongs that are rotated downward. A forehead flap is rotated into the area above the eyelid, the flap from above the eyelid is rotated to infra-orbital area and the flap from the infraorbital area that includes the free nasal ala of the cleft is rotated into place.

Results and conclusions: These two flap designs show good results and can be used to augment the treatment options for repairing Tessier no. 2 and 3 facial clefts.

Keywords: Facial clefts; Tessier clefts; Tessier no. 2 cleft; Tessier no. 3 cleft.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1a
Figure 1a
Marking for the nasal dorsum rotational flaps for correction of Tessier no. 2 facial cleft showing its parallelogram shape and three free edges
Figure 1b
Figure 1b
Superficial and deep dissection and open rhinoplasty of the Nasal dorsum rotational flaps for correction of Tessier no. 2 facial cleft
Figure 1c
Figure 1c
Alar reconstruction using the nasal dorsum rotational flaps for correction of Tessier no. 2 facial cleft
Figure 1d
Figure 1d
Closure of the nasal dorsum rotational flaps for correction of Tessier no. 2 facial cleft
Figure 2a
Figure 2a
Marking for the forehead-eyelid-nasal transposition flaps for correction of Tessier no. 3 facial cleft showing the two limbs over the forehead and inferior to medial brow
Figure 2b
Figure 2b
Rotation of the forehead flap into the medial brow and the medial brow flap into the subciliary area using the forehead-eyelid-nasal transposition flaps for correction of Tessier no. 3 facial cleft
Figure 2c
Figure 2c
Closure of the forehead-eyelid-nasal transposition flaps for correction of Tessier no. 3 facial cleft
Figure 3a
Figure 3a
Pre- and post-operative frontal view photographs of the NDF for correction of Tessier no. 2 facial cleft
Figure 3b
Figure 3b
Pre- and post-operative worms eye view photographs of the NDF for correction of Tessier no. 2 facial cleft
Figure 3c
Figure 3c
Pre- and post-operative profile view photographs of the NDF for correction of Tessier no. 2 facial cleft
Figure 4a
Figure 4a
Pre- and post-operative frontal view photographs of the foreheadeyelid-nasal transposition flaps for Tessier no. 3 facial cleft
Figure 4b
Figure 4b
Pre- and post-operative worms eye view photographs of the forehead-eyelid-nasal transposition flaps for Tessier no. 3 facial cleft
Figure 4c
Figure 4c
Pre- and post-operative profile view photographs of the foreheadeyelid-nasal transposition flaps for Tessier no. 3 facial cleft
See this image and copyright information in PMC

References

    1. Zhou YQ, Ji J, Mu XZ, Zhang RH, Wei M, Yu ZY. Diagnosis and classification of congenital craniofacial cleft deformities. J Craniofac Surg. 2006;17:198–201. - PubMed
    1. Ortiz Monasterio F, Fuente del Campo A, Dimopulos A. Nasal clefts. Ann Plast Surg. 1987;18:377–97. - PubMed
    1. Tessier P. Anatomical classification facial, cranio-facial and latero-facial clefts. J Maxillofac Surg. 1976;4:69–92. - PubMed
    1. Fearon JA. Rare craniofacial clefts: A surgical classification. J Craniofac Surg. 2008;19:110–2. - PubMed
    1. Ozek C, Gundogan H, Bilkay U, Cankayali R, Guner U, Gurler T, et al. Rare craniofacial anomaly: Tessier no 2 cleft. J Craniofac Surg. 2001;12:355–61. - PubMed