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
Case Reports
. 2023 Aug 11;35(1):93-95.
doi: 10.4103/joco.joco_153_22. eCollection 2023 Jan-Mar.

Tessier Number 9 Craniofacial Cleft Associated with Goldenhar Syndrome and Its Surgical Management: A Report of a Rare Case

Abbas Bagheri  1   2 , Mohadeseh Feizi  1   2 , Mehdi Tavakoli  3
Affiliations
Case Reports

Tessier Number 9 Craniofacial Cleft Associated with Goldenhar Syndrome and Its Surgical Management: A Report of a Rare Case

Abbas Bagheri et al. J Curr Ophthalmol. .

Abstract

Purpose: To report surgical repair of a rare case of Tessier number 9 craniofacial cleft.

Methods: Case report.

Results: Tessier number 9 craniofacial cleft is the rarest cleft anomaly. This article reports a congenital eyelid coloboma in a 21-year-old woman that involved the lateral third of the left upper eyelid and extended to the lateral canthus, consistent with number 9 craniofacial cleft Tessier classification. The additional findings included a fibrotic band between the globe and the remnant of the upper lid, which caused a small-angle exotropia. There were also skin appendages in the preauricular area and the inner surface of the nasal columella consistent with Goldenhar syndrome. The eyelid coloboma was repaired by releasing the adhesions and using a composite graft of the hard palate to repair the posterior lamella. The anterior lamella was repaired by creating a skin advancement flap. The esthetic and functional outcomes were acceptable in the 2-year postoperative follow-up period.

Conclusion: The composite hard palate graft can be used to repair posterior lamella defect in the case of Tessier number 9 craniofacial cleft.

Keywords: Craniofacial cleft; Eyelid coloboma; Hard palate graft; Tessier number 9 cleft.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Clinical photograph of the patient. (a) Left upper eyelid coloboma at the lateral third of the eyelid and small-angle left exotropia, (b) Lateral view of the eyelid coloboma (black arrow) and skin appendages in front of the ear tragus (white arrow), (c) Attachment of the globe to the eyelid remnant with fibrotic tissue, (d) Skin appendages on the inner surface of the nasal columella (white arrow)
Figure 2
Figure 2
Clinical photograph of the patient after the operation. (a) Anterior view, (b) Lateral view
See this image and copyright information in PMC

References

    1. Kawamoto HK., Jr The kaleidoscopic world of rare craniofacial clefts: Order out of chaos (Tessier classification) Clin Plast Surg. 1976;3:529–72. - PubMed
    1. David DJ, Moore MH, Cooter RD, Chow SK. The Tessier number 9 cleft. Plast Reconstr Surg. 1989;83:520–7. - PubMed
    1. Dumortier R, Delhemmes P, Pellerin P. Bilateral Tessier No. 9 cleft. J Craniofac Surg. 1999;10:523–5. - PubMed
    1. Darzi MA, Chowdri NA. Oblique facial clefts: A report of Tessier numbers 3, 4, 5, and 9 clefts. Cleft Palate Craniofac J. 1993;30:414–5. - PubMed
    1. Bubanale SC, Kurbet SB, De Piedade Sequeira LM. A rare case of cleft number nine associated with atypical cleft number two. Indian J Ophthalmol. 2017;65:610–2. - PMC - PubMed

Publication types