Oblique facial cleft with anophthalmia in a mentally normal child.

An oro-ocular facial cleft with anophthalmia, classified as Tessier cleft no. 4, was satisfactorily corrected by a series of conservative procedures, including tube pedicle flap transfer, Z plasties, and bone grafting for orbital socket and zygomatic reconstruction. Beginning in 1975 when the patient was 4 months old, most of the reconstructions were performed before the routine tissue expansion and microsurgical tissue transfer techniques that are common today. The patient's development is normal and he is intellectually more advanced than most children his age. Correction of increasing asymmetry between growing and nongrowing regions of the skull in this young boy will probably be required.