Rare craniofacial clefts: Surgical management protocols

Abstract

BackgroundStandardization of surgical protocols is an evolving issue owing to the low incidence of rare craniofacial clefts. In this article, we aimed to share our surgical management of rare craniofacial clefts and evaluate the postoperative results. MethodsThis study was conducted from 2013 to 2022, including patients who presented with craniofacial clefts. The results were assessed based on parents’ satisfaction and objective evaluations by two independent observers. ResultsWe received a total of 3679 patients with cleft anomalies; of these, 61 patients with 89 rare craniofacial clefts were observed with a prevalence of 2.42/100. The male to female ratio was 1:1.35. Craniofacial cleft “4” and “5” were the most common, with 17 (19.1%) and 16 (17.98%), respectively. Multiple craniofacial clefts were observed in 37.7% of patients. Associated craniofacial anomalies were found in 39.34% patients. In 71.6% of patients, the parents were very satisfied with the results. Based on two independent observer scores, 70.27% of the patients scored good. ConclusionThe rare nature of craniofacial clefts and involvement of various structures make the standardization of surgical procedures very challenging. Our experience with these clefts will help new surgeons both in didactics and in technical aspects of patient management. Key Points1. We aim to share our experience with rare craniofacial clefts.2. Each cleft presents with its own unique reconstructive challenges. Literature describes many techniques for each cleft with dozen permutations. We present a simplified techniques that has worked for us over the years for all tessier clefts in this article.