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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Treacher-collins syndrome and hemifacial microsomia [ 7 ] are frequently associated with macrostomia [ 8 ].

The goal of macrostomia reconstruction is to achieve functional, symmetrical, and accurate oral commissure with minimal scar. Nasal intubation was used for general anaesthesia. Patient was posted under general anaesthesia for the correction of ill-formed commissure.

Lower lip midpoint was determined on a point corresponding to the midline of the upper lip and midline of columella of the nose. Preoperative photographs showing the frontal and lateral view of the patient.

This leaves a V-shaped defect. At 2-month followup, the oral commissures are symmetric.

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

Showing of 16 references. The superficial portion associates with the maxilla and septum marcostomia and the mandible below. Antenatal and birth history was nonsignificant. 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.

Case Reports in Dentistry. Although the former is a more acceptable theory, Gorlin and others claim that post-merging tear is the cause [ 56 ] and it is thought to be part of the manifestation of hemifacial microstomia, the second most common congenital craniofacial anomaly [ 2 ]. The follow-up period in this retrospective study ranged from 3 to 21 years. Introduction Transverse facial cleft is a rare congenital anomaly with only 21 cases reported in the world literature. Twelve primary cases of macrostomia underwent surgical repair between and Modified technique in surgical correction of macrostomia.


Both the points coincided, and the entire surgical correction was centered on these points. Br J Plast Surg ; On the cleft side, point A was marked on the upper lip and point B was marked on the lower lip at the vermilion cutaneous junction Mavrostomia 2. Financial support and sponsorship Nil.

It may be unilateral, extending along a line from the commissure to the tragus or bilateral.

Repair for Congenital Macrostomia: Vermilion Square Flap Method

The ideal outcome of surgery is the result of proper placement of scars between different aesthetic subunits of face. This technique in our experience is easy and the result is excellent.

Incisions were made after infiltration of adrenaline solution in concentration 1 inand the excess tissue is excised. However, these methods of reconstruction have their scars located at the angle.

Because the corner of the normal macroshomia is not a corner but rather a smooth and continuous segment of the vermilion [ 26 ], it is difficult to achieve a natural contour of the corner of the mouth when the scar is located at the angle.

New surgical technique for macrostomia repair with two triangular flaps. Problems associated with macrostomia include aesthetic disharmony and functional problems like feeding difficulties, drooling, speech incoherence, and difficulty in blowing.

This maneuver is of vital importance in creating competence, shape maxrostomia contour at the commissure. Straight line closure of congenital macrostomia. We report an excellent result of applying this technique on a 6-year-old girl with unilateral macrostomia.

The lateral extent of the cleft was located at the anterior border of the masseter muscle. This drawback of Z-plasty led to development of straight line closure [ 25 ]. Advancement of oral commissure in correcting mild macrostomia.


This is an open access article macrpstomia under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Anatomically and functionally, macrkstomia orbicularis oris muscle can be divided into two distinctive layers, superficial and deep [ 19 ].

This report presents the case of a 3-month-old boy with isolated bilateral macrostomia for whom straight line closure was performed on both sides. We recommend this method for patients with mild to moderate macrostomia. Introduction Transverse facial or Tessier No. Overlapping myoplasty is used as it gives the natural overlap of upper lip over the lower lip.

The cleft of macrostomia includes a three layered defects of the skin, muscle and mucosa. Gorlin believes that the lateral facial clefts are postmerging tears as there is considerable clinical variation [ 3 ]. In this paper, we present a six-year-old girl with unilateral macrostomia with preauricular skin tags and malformation of pinna on ipsilateral side treated with vermillion-square flap method.

In the current case, a perpendicular line was dropped from the medial margin repaor the pupil, and the point at which the color of vermilion changes from normal vermilion to cleft vermilion was marked. Surgical technique for the correction of macrostomia should address skin, muscle, and mucosa.

We report a case of macrostomia corrected with Z-plasty closure for skin, overlapping muscle closure, and triangular mucosal flap for commissure, with a review on existing techniques. In this article, the authors report their novel technique and the results obtained, assessed retrospectively. The surgical methods for repairing congenital macrostomia should be carefully selected from both functional and aesthetic points of view.

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