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KMID : 0952820190220020067
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Journal of Korean Cleft Lip & Palate Association
2019 Volume.22 No. 2 p.67 ~ p.73
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Surgical Correction of Tessier No. 7 Facial Cleft of Goldenhar Syndrome Patient: A Case Report
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Choung Pill-Hoon
Ha Sung-Ho
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Abstract
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Goldenhar syndrome is a disease that caused by affected structures induced by the first and second bronchial arch. It is characterized by various clinical symptoms such as ocular abnormality, external auditory canal stenosis, ear tag, mandibular dysplasia, and spinal abnormality. Since the fusion of the maxillary and mandibular processes is also affected, lateral cleft at commissure of mouth appears commonly. According to Tessier s craniofacial cleft classification in 1976, lateral cleft at commissure of mouth corresponds to Tessier No. 7 classification, characterized by philtrum displacement due to non-union and improper development of muscles around the mouth. There is no definite time for the treatment of these patients with facial anomalies, but it is necessary to perform surgical correction at the appropriate time considering the functional and social aspects of the patient. Patients with Goldenhar syndrome are often accompanied by other systemic diseases. Therefore, it is advisable to perform oral and maxillofacial surgery after evaluate the systemic conditions of the patient. There are few surgical methods to correction Tessier No. 7 facial clefts, but the gold standard is not established. In this case, surgical correction of lateral cleft was performed using simple suture method based on reorientation of orbicularis oris muscle, where reorientation of zygomaticus major muscle and risorius muscle. Triangular abundant skin of mouth commissure was rotated to intraoral side and used appropriately to closure. After the operation, the patient’s symmetry of the lip was recovered, and the functional recovery of the orbicularis oris muscle was achieved.
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KEYWORD
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Goldenhar syndrome, Tessier No.7 cleft, Lateral cleft, Macrostomia
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