NDLI: Ocular manifestations of oblique facial clefts.

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Ocular manifestations of oblique facial clefts.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kawamoto, Henry K. Ortube, Maria Carolina Dipple, Katrina Setoguchi, Yoshio Demer, Joseph L.
Description	Country affiliation: United States Author Affiliation: Ortube MC ( Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.)
Abstract	INTRODUCTION: In the Tessier classification, craniofacial clefts are numbered from 0 to 14 and extend along constant axes through the eyebrows, eyelids, maxilla, nostrils, and the lips. We studied a patient with bilateral cleft 10 associated with ocular abnormalities. METHOD: Clinical report with orbital and cranial computed tomography. RESULTS: After pregnancy complicated by oligohydramnios, digoxin, and lisinopril exposure, a boy was born with facial and ocular dysmorphism. Examination at age 26 months showed bilateral epibulbar dermoids, covering half the corneal surface, and unilateral morning glory anomaly of the optic nerve. Ductions of the right eye were normal, but the left eye had severely impaired ductions in all directions, left hypotropia, and esotropia. Under anesthesia, the left eye could not be rotated freely in any direction. Bilateral Tessier cleft number 10 was implicated by the presence of colobomata of the middle third of the upper eyelids and eyebrows. As the cleft continued into the hairline, there was marked anterior scalp alopecia. Computed x-ray tomography showed a left middle cranial fossa arachnoid cyst and calcification of the reflected tendon of the superior oblique muscle, trochlea, and underlying sclera, with downward and lateral globe displacement. DISCUSSION: Tessier 10 clefts are very rare and usually associated with encephalocele. Bilateral 10 clefts have not been reported previously. In this case, there was coexisting unilateral morning glory anomaly and arachnoid cyst of the left middle cranial fossa but no encephalocele. CONCLUSIONS: Bilateral Tessier facial cleft 10 may be associated with alopecia, morning glory anomaly, epibulbar dermoids, arachnoid cyst, and restrictive strabismus.
ISSN	10492275
e-ISSN	15363732
DOI	10.1097/SCS.0b013e3181ecc4cd
Journal	Journal of Craniofacial Surgery
Issue Number	5
Volume Number	21
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Cleft Palate Craniofacial Abnormalities Eye Abnormalities Tomography, X-ray Computed Abnormalities, Multiple Alopecia Arachnoid Cysts Dermoid Cyst Infant, Newborn Strabismus Research Support, Non-u.s. Gov't Discipline Medicine Discipline Otorhinolaryngology Discipline Surgery
Content Type	Text
Resource Type	Article Case study
Subject	Otorhinolaryngology Surgery

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