| Background:The oblique facial clefts are congenital craniofacial malformations affecting the paramedian line of facial structures. Correction of the oblique facial clefts is difficult and involves reconstruction of bones and soft tissues. The authors have developed a computer-aided sequential surgical procedure for oblique facial clefts, including mandibular outer cortex autografting, medial canthal ligament reduction and fixation.Methods:From January in2004to December in2013,12patients (nine female, three male) with oblique facial clefts were treated with the sequential surgical procedure in our clinic. The mean patient age at first surgery was18years (range,13to25years). Preoperative three-dimensional computer-assisted surgical simulations assisted the surgeries. A retrospective review of the patients’clinical, photographic, and radiographic records was performed.Results:All patients achieved significant treatment effects and high satisfaction. The patients’self-assessed scores on a10-point scale of deformity severity were lower (p<0.001) after surgery and remained stable after6to12months (p=0.069). Good repositioning of the inner canthus was achieved (p<0.001) with no significant relapse (p=0.096). The average recovery of mandibular donor sites was48.44±16.89%(range,from11.03%to71.33%). Grafted bone absorption was28.67±14.39%(range,from12.58%to69.17%).The absorption of grafted bone was not significantly different at different recipient sites. Only minor complications occurred in six cases.Conclusions:This procedure was an effective treatment for oblique facial clefts, resulting in high satisfaction, remarkable improvements in facial symmetry, little skin scarring, acceptable degree of bone graft resorption, and dramatic recovery of mandibular donor sites. Computer-assisted analysis and surgical simulation of oblique facial clefts effectively describes characteristic skeletal deformities and provides a useful guide to surgical reconstruction. |
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