Atypical Facial Clefts From Northcentral Nigeria, Review of 36 Cases.

OBJECTIVE: This study aims to present the pattern and management of atypical facial clefts from a Nigerian population.

DESIGN: This is a retrospective study of patients seen during series of surgical outreach programs in North Central Nigeria, between 2011 and 2017. All cases of atypical facial clefts encountered were evaluated for the pattern of presentation using Tessier classification system. All of them were surgically repaired and outcome was determined using a Likert scale. Data were presented using descriptive statistics.

SETTING: Outreach programs in North Central Nigeria by Cleft & Facial Deformity Foundation.

RESULTS: Thirty-six patients, 19 (52.8%) males and 17 (47.2%) females, were studied. The age range was 1 week to 34 years, with mean (standard deviation) of 11.2 (11.8) years. Fifty-eight cleft cases were recorded, with Tessier 1 being the commonest (n = 14; 24.1%) cleft type. There were 35 (60.3%) cases of middle cleft, 14 (24.2%) cases of oblique cleft, and 9 (15.5%) cases of lateral cleft. Typical cleft lip and palate coexisted with atypical facial cleft in 2 (5.6%) patients. Cleft was found to be median in 12 (33.3%) patients and right sided in 9 (25%) patients. Majority (n = 24, 66.7%) of the cases were repaired by simple excision plus direct closure with successful outcome.

CONCLUSIONS: Numerical classification by Paul Tessier has reduced the inconsistencies of nomenclature among practitioners. Majority of atypical facial clefts could be treated by simple techniques with satisfactory outcomes. However, the more complex cases will require multistaged surgical approach.