Surgical Management of Median Cleft Lip Extending as Far as Alveolus Using Bone Grafting.

Median clefts, which run through the midline of the upper lip, and alveolus are considered a type of craniofacial cleft. A Tessier number 0 median cleft lip is the rarest, and there are few reports concerning its surgical management. Here, we describe the case of a 6-year-old boy who presented at our hospital with a median cleft and alveolus of the upper lip with a shortened bifid frenulum. Inverted-V and Z-plasty incisions were performed for the median cleft and iliac bone grafting for the midline alveolus. At 1 year 5 months later, the postoperative course was uneventful, and proper approximation of the orbicularis oris muscle and vermilion were achieved, with a symmetrical Cupid's bow and labial tubercle and philtrum.