Rare Craniofacial Clefts

Abstract

Keel-shaped maxilla with anterior teeth angled mediallyAnterior open bite Cleft in the primary and secondary palate Duplicated anterior nasal spine and bonyseptumVertical maxillary hypoplasia Broad and flattened nasal bones Enlargement of ethmoid and sphenoid sinuses4. Bony characteristics, in cases of agenesis or hypoplasia:Absent nasal bone and bony septum Hypoplastic ethmoid bones Orbital hypotelorism Eye deformities Congenital forebrain deformities5. Soft tissue and bony characteristics (lower face):A number 30 cleft is the caudal extension of a number 0 cleftMedian cleft between the central incisors and mandibular symphysisNeck deformities Absent hyoid bone Abnormal thyroid cartilage Atrophic neck muscles Bifid tongue AnkyloglossiaC. Number 1 Cleft1. Soft tissue characteristics:Facial cleft is the same as for a common cleft Notched alar dome Broad columella Nasal tip and septum are deviated away fromthe cleftFurrows along the nasal dorsum Cleft is medial to the malpositioned medialcanthusVertical distopia Telecanthus2. Bony characteristics:Keel-shaped maxilla with medially facing teeth Anterior open bite Cleft is between the central and lateral incisorsand into the pyriform aperture, through the primary and secondary palate, and then between nasal bone and maxillaFlattened nasal bones Ethmoid hypertrophyD. Number 2 Cleft1. Soft tissue characteristics:Cleft lip lies in the region of common clefts Hypoplasia of the mid-alar cartilage Flattened lateral nose Broad nasal dorsum Cleft passes medial to the palpebral fissure Normal lacrimal drainage Laterally displaced medial canthus2. Bony characteristics:Cleft between the lateral incisor and canine into the pyriform sinusIntact maxillary sinus Complete cleft of theprimaryand secondarypalate Intact nasal septum, deviated away fromthe cleftPasses between the nasal bones and maxilla Hypoplastic ethmoid and frontal sinuses Orbital hypertelorismE. Number 3 Cleft1. Soft tissue characteristics:Most common Tessier cleft Cleft is along philtral column into the nasal floor Vertical shortening between the ala andlower lidShort nose Upward pull of the alar base Disrupted lacrimal system and lower canaliculus Lower lid colobomas.