MACROSTOMIA REPAIR PDF
Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see Bilateral macrostomia, muscle repair, straight line closure. Congenital macrostomia is a relatively rare deformity. A number of different methods for its correction have been reported in the past. Here, we report our refined. Congenital macrostomia (transverse facial cleft) is a relatively rare anomaly. Surgical methods used to correct this anomaly include commissuroplasty.
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Keywords Bilateral macrostomia, muscle repair, straight line closure.
Case Reports in Dentistry
Because the corner of the normal mouth is not a corner but rather a smooth and continuous segment of the vermilion [ 26 ], it is difficult to achieve a natural contour of the corner of the mouth when the scar is located at the angle.
This leaves a V-shaped defect.
Both the points coincided, and the entire surgical correction was centered on these points. Although the creation of a symmetric neocommissure is imperative, this presents a technical challenge. The macrostokia muscle bundles at the cleft cheek were sutured into a side-to-side fashion. Subscribe to Table of Contents Alerts. A lazy W-plasty was designed for closure of the skin of the cleft cheek.
Straight line closure for correction of congenital isolated bilateral macrostomia
Initial workers used Z-plasty to close transverse facial cleft [ 2324 ] but later on it was noticed that the Z-plasty left a more visible scar. In most of the series in the literature transverse cleft accounts for less than 0. Simple straight line closure or improper approximation of muscle bundles might result in fish mouth deformity. We report an excellent result of applying macrostpmia technique on a macrostomua girl with unilateral macrostomia.
However, these methods of reconstruction have their scars located at the angle. Although the former is a more acceptable theory, Gorlin and others claim that post-merging tear is the cause [ 56 ] and it is thought to be part of the manifestation of hemifacial microstomia, the second most common congenital craniofacial anomaly [ 2 ]. Macrostomia is a rare congenital deformity with an incidence of 1 in 60, to 1 inlive births [ 12 ].
The ideal outcome of surgery is the result of proper placement of scars between different aesthetic subunits of face. View at Google Scholar O. Vermilion square flap method can be used but it is technique sensitive and might give an unsightly scar at vermilion cutaneous junction of the commissure. The skin, muscle, and mucosal components of the deformity were separately repaired using a modification of Kaplan’s technique.
It may be unilateral, extending along a line from the commissure to the tragus or bilateral. Transverse clefts develop either due to failure of the maxillary and mandibular processes to fuse or a disruption in the processes after fusing.
Macrostomia: A Review of Evolution of Surgical Techniques
Isolated transverse clefts are rare [ 3 ]. Small Z-plasty for skin closure will avoid linear contractures. Indian J Plast Surg ; Mqcrostomia of Contents Alerts. Subscribe to Table of Contents Alerts. It could vary from slight widening of the mouth to a cleft extending back to the ear; they are usually unilateral and do not extend beyond the anterior border of the masseter.
It results from failure of fusion of maxillary and mandibular process [ 4 ]. Charles N Verheyden Annals of plastic surgery It is more commonly unilateral than bilateral.
Repair for Congenital Macrostomia: Vermilion Square Flap Method
macfostomia The scar is placed at the upper lip. References Publications referenced by this paper. The aesthetic outcome of these surgeries depends not only on the placement of scars along the natural skin creases but also on their showup during facial expressions.
The advantage of this technique is that the position of the commissure of the mouth can be adjusted intraoperatively according to the extent of macrostomia.
Triangular mucosal flaps will result in a natural looking commissure and can avoid transposition of the skin. Gorlin believes that the lateral facial clefts are postmerging tears as there is considerable clinical variation [ 3 ]. Patient was examined thoroughly to rule out other congenital anomalies and investigated for PAC.