Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see Bilateral macrostomia, muscle repair, straight line closure. Congenital macrostomia is a relatively rare deformity. A number of different methods for its correction have been reported in the past. Here, we report our refined. Congenital macrostomia (transverse facial cleft) is a relatively rare anomaly. Surgical methods used to correct this anomaly include commissuroplasty.

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Showing of 16 references. Osamu FukudaHiroshi Takeda Annals of plastic surgery Although this is a rare deformity, it causes functional and cosmetic problems which are difficult to correct. The affliction can vary from slight widening of the mouth to a cleft extending to the ear.

Bilateral macrostomia as an isolated deformity and its repair with a modified technique

Cleft Palate Craniofac J ; Macrostommia Z-plasty and vermilion square flap methods are technique sensitive and require meticulous execution in order to avoid unsightly scar. But mostly repai clefts are unilateral and do not extend beyond the anterior border of the masseter [ 4 ]. Madrostomia considerations in the repair of macrostomia. Financial support and sponsorship Nil. The same method was applied to all 12 cases in the reconstruction of a natural appearance and dynamic function of the oral commissure, and the results over several years showed satisfactory outcomes.

Problems associated with macrostomia include aesthetic disharmony and functional problems like feeding repajr, drooling, speech incoherence, and difficulty in blowing. Vermilion square flap for correction of bilateral macrostomia – A case report. After a thorough evaluation to rule out any associated anomalies, the child was scheduled for surgical correction. The deep layer of orbicularis oris muscle consists of fibers that arise from other facial muscles. It results from failure of fusion of maxillary and mandibular process [ 4 ].


Haematological investigations are within normal limits.

At two-month followup, the oral commissures are symmetric, the scars are inconspicuous, and the overall balance of facial contour and lip is excellent. However, these methods of reconstruction have their scars located at the angle. The remaining parameters such as occlusion and temporomandibular joint functions are normal.

Following nasal intubation, the neocommissure was determined by dropping a vertical line from the medial margin of both pupils and marking the well-defined change in color from the normal vermilion to cleft mucosa. Macrostomia is a rare deformity with variations in its presentation.

Straight line closure results in formation of dog ear as the lengths of upper mzcrostomia lower incisions were uneven [ 11 ]. Initial workers used Z-plasty to close transverse facial cleft [ 2324 ] but later on it was noticed that the Z-plasty left a more visible scar. In the current case, a perpendicular line was macrpstomia from the medial margin of the pupil, and the point at which the color of vermilion changes from normal vermilion to cleft vermilion was marked.

Macrostomia: A Review of Evolution of Surgical Techniques

Transverse clefts develop either due to failure of the maxillary and mandibular processes to fuse or a disruption in the processes after fusing. It is not surprising that the condition is usually associated with other defects because of the many facial structures developing simultaneously.

The authors declare that there is no conflict of interests regarding the publication of this paper. This leaves a V-shaped defect.

Straight line closure for correction of congenital isolated bilateral macrostomia

It could vary from slight widening of the mouth to a cleft extending back to the ear; they are usually unilateral and do not extend beyond the anterior border of the masseter.

At seven weeks of gestation the lips separate from the alveolar areas with the formations of a vestibule and the maxillary and mandibular swellings then merge laterally to form the cheeks. Conficts of interest There are no conflicts of interest.


It is also hoped that the authorities will enact and enforce laws to ensure the rights of such babies, especially right to care and life [ 18 ].

Triangular mucosal flaps will result in a natural looking commissure and can avoid transposition of the skin. The severity of these clefts also differs.

Charles N Verheyden Annals of plastic surgery Isolated transverse clefts are rare [ 3 ]. Simple straight line closure or improper approximation of muscle bundles might result in fish mouth deformity. Rpair Report We report a case of year-old boy with rdpair chief complaint of macrostomiz mouth and drooling of saliva Figure 1.

Z-plasty aids in lengthening the transverse deficient cheek. An incidence of about 1 in 60, births to 1 inlive births has been recorded [ 5 ]. However, the choice of technique should be based on the subclassification of defect in order to disguise the scar in the natural skin lines.

Commissure on the noncleft side is marked. A 6-year-old female patient visited the Department of Pedodontics and Preventive Dentistry with a chief complaint of wide mouth opening and preauricular skin tags since birth Figures 1 a and 1 b. On systemic evaluation, repaif other skeletal abnormalities were found. Abstract Macrostomia is a congenital deformity resulting from failure of fusion of maxillary and mandibular process.

Surgical repair for congenital macrostomia:

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