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Войти в исследования The Journal of craniofacial surgery · 2026
Surgical Management of Uncorrected Adult Bilateral Tessier No. 4 Clefts: A 2-Stage Reconstruction Using a Bipaddled ALT Free Flap and Z-Plasty.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sơn Trần Thiết, Nghĩa Phan Tuấn, Anh Hoàng Tuấn
Аннотация
BACKGROUND: Bilateral Tessier No. 4 clefts are rare craniofacial anomalies involving the lip, maxilla, and lower eyelids. In adults, untreated cases lead to severe midface hypoplasia and cicatricial ectropion, posing significant reconstructive challenges beyond local tissue rearrangement.
METHODS: A 22-year-old male with untreated bilateral Tessier No. 4 clefts underwent staged reconstruction. A bipaddled anterolateral thigh (ALT) free flap, based on 2 perforators, was used for midface augmentation and lower eyelid coverage. Secondary refinement at 2 months used Z-plasty to repair lip clefts and restore orbicularis oris continuity.
RESULTS: The flap survived completely without complications. At 20 months, the patient showed improved facial symmetry with complete resolution of ectropion and epiphora. Midface volume was maintained, and oral function and aesthetics were restored.
CONCLUSIONS: A staged approach combining microsurgical free tissue transfer and local flap refinement provides a reliable solution for complex craniofacial reconstruction, especially in congenital deformities.
METHODS: A 22-year-old male with untreated bilateral Tessier No. 4 clefts underwent staged reconstruction. A bipaddled anterolateral thigh (ALT) free flap, based on 2 perforators, was used for midface augmentation and lower eyelid coverage. Secondary refinement at 2 months used Z-plasty to repair lip clefts and restore orbicularis oris continuity.
RESULTS: The flap survived completely without complications. At 20 months, the patient showed improved facial symmetry with complete resolution of ectropion and epiphora. Midface volume was maintained, and oral function and aesthetics were restored.
CONCLUSIONS: A staged approach combining microsurgical free tissue transfer and local flap refinement provides a reliable solution for complex craniofacial reconstruction, especially in congenital deformities.