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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This drawback of Z-plasty led to development of straight line closure [ 25 ]. The authors’ technique is very useful in the primary surgery for macrostomia, as the dynamic action of muscle fibers is preserved, if the muscle is not dissected from the skin in the cleft margin that includes the two medial small triangular flaps.

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

Bilateral macrostomia in one of monozygotic twins. Introduction Macrostomia is a rare congenital deformity with an incidence of 1 in 60, to 1 inlive births [ 12 ]. Straight line macrsotomia closure or overlapping myoplasties are used for muscle reconstruction. Transverse facial or Tessier No. The extent of clefting in the muscle ranges from mild which is confined to the orbicularis oris to the buccinator or even extends backwards to the masseter muscle.

Macrostomia: A Review of Evolution of Surgical Techniques

At 2-month followup, the oral commissures are symmetric. Commissure on the noncleft side is marked. Antenatal and birth history was nonsignificant.


Table of Contents Alerts. Although this is a rare deformity, it causes functional and cosmetic problems which are difficult to correct. Bilateral filter Kaplan—Meier estimator.

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.

Straight line closure for correction of congenital isolated bilateral macrostomia

Orbicularis oris muscle is dissected from labial and mucosal sides. In most of the series in the literature transverse cleft accounts for less than 0. Case Reports in Dentistry. Introduction Transverse facial or Tessier No.

It is usually partial but rarely complete.

Vermilion square flap [ 1920 ] prevents migration of commissure laterally and it macroxtomia linear contracture of scar as well. Transverse facial cleft is a rare congenital anomaly with only 21 cases reported in the world literature.

Two-month postsurgical photographs reveal repaur symmetry of commissures both at rest and at smiling with minimal scar Figures 3 and 4. Rev Stomatol Chir Maxillofac ; One should consider the symmetry both in vertical and in horizontal plane as improper techniques might result in asymmetry [ 8 ]. Plast Reconstr Surg ; Sterile skin and mucosa are excised.

The affliction can vary from slight widening of the mouth to a cleft extending to the ear. Patient was followed up weekly for the first month and thereafter monthly for 2 months Figures 5 a and 5 b.

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Case Report Eepair 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. The deep component has a sphincteric function. The same repairr was applied to all 12 cases in the reconstruction of a natural appearance and dynamic function of the oral commissure, and the results over repaur years showed satisfactory outcomes.


In this report, the straight line repair of isolated bilateral repiar macrostomia is presented for the first time. On systemic evaluation, no other skeletal abnormalities were found. Indexed in Web of Science. Intraoperative photographs with proposed incision markings showing Z plasty limbs and mucosal flaps white triangles.

This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any marcostomia, provided the original work is properly cited. Abstract Macrostomia is a congenital deformity resulting from failure of fusion of maxillary and mandibular process. The upper muscle fibers of the deep layer decussate into the lower lip, and the lower muscle fibers decussate into the upper lip.

Congenital bilateral macrostomia is a very rare deformity of the mouth, and it is still rarer to see cases of isolated bilateral macrostomia. View at Google Scholar O. Macrostomia is a congenital deformity resulting from failure of fusion of maxillary and mandibular process. We have used triangular mucosal flaps for closure of commissure as it achieves continuous dry red and wet vermilion.

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