Transverse facial cleft: An uncommon occurrence

Abstract

Background: Transverse facial cleft (TFC) is a rare facial cleft occurring at the angle of the mouth and runs in a horizontal direction posteriorly for variable distances. The increasing number of free cleft surgeries performed at various treatment centres across Nigeria sponsored by Non-Governmental Organizations suggests that practicing cleft surgeon will invariably encounter one or more rare variants of facial clefts such as transverse facial clefts. The objective of this paper is to review available literature on the aetiology, classification, presentation and surgical management and to document our experience with transverse facial cleft in our practice. Methods: A literature review was conducted using Pubmed and Google scholar databases. It concentrated on manuscripts and overviews published in the last ten years. The pattern of presentation and surgical management of patients who presented to our practice over a period of 3 years were also discussed. Results: Four patients aged 4months, 6months, 7 and 17years were managed in the period under review. Two of the patients presented with bilateral TFCs with the other two presenting as unilateral TFCs with no syndromic association. All four patients were managed surgically using a straight line repair technique. Conclusion: The rarity of transverse facial cleft has made it difficult to design a specific treatment method however, despite the controversy over the preferred repair technique, good aesthetic and functional outcome was observed using the straight line repair technique. in 4 cases treated in our centre.