Facial Aesthetic Units Reconstruction Of Craniofacial Clefts

Objective:We intended to find the best reconstructive methods for craniofacial clefts, by means of analyzing the involvement of facial aesthetics units in different types of craniofacial clefts and its corresponding treatment.Methods:32cases of craniofacial clefts repair from February2005to February2013in the5th Department in Plastic Surgery Hospital were retrospectively reviewed. There were15male patients and17female, whose mean age is16.3years old, including5midline clefts,3paramedian clefts,10orbital clefts,12lateral clefts and2complex clefts.22cases had treatments previously. All patients received one or more reconstructive surgeries and the mean number of operation is1.7. Patients’ deformity characters, operation methods and outcomes were evaluated.Results:The highest incidence of craniofacial clefts is orbital clefts and lateral clefts. Craniofacial clefts can affect every facial unit, and the most frequently involved ones are eyes,cheek and nose.32patients receieved62kinds of reconstructive surgery. Operations can be divided into two kinds, that is bone reconstruction or soft tissue reconstruction. Bone reconstructive methods are bone osteotomy,autogenous bone graft and artificial material implantation. Soft tissue reconstruction contain local skin flap transfer, composite tissue transplantion and autogenous fat injection. Many patients were treated more than once. All the patients’ appearances are greatly improved.Conclusion:Craniofacial clefts can affect every facial unit. Because of their variability and complexity, constructive surgery has wide varieties. Surgeons should choose appropriate methods to reconstruct the bone and soft tissue defect according to the type and degree of deformities. And facial aesthetic units should be respected. Place the incisions along the borders of facial units or subunits and replace the lost tissue with grafts or flaps of similar histology, thickness, and texture can achieve a better result.