ABSTRACT
Keel-shaped maxilla with anterior teeth angled medially
Anterior open bite Cleft in the primary and secondary palate Duplicated anterior nasal spine and bony
septum
Vertical maxillary hypoplasia Broad and flattened nasal bones Enlargement of ethmoid and sphenoid sinuses
4. Bony characteristics, in cases of agenesis or hypoplasia:
Absent nasal bone and bony septum Hypoplastic ethmoid bones Orbital hypotelorism Eye deformities Congenital forebrain deformities
5. Soft tissue and bony characteristics (lower face):
A number 30 cleft is the caudal extension of a number 0 cleft
Median cleft between the central incisors and mandibular symphysis
Neck deformities Absent hyoid bone Abnormal thyroid cartilage Atrophic neck muscles Bifid tongue Ankyloglossia
C. Number 1 Cleft
1. Soft tissue characteristics:
Facial cleft is the same as for a common cleft Notched alar dome Broad columella Nasal tip and septum are deviated away from
the cleft
Furrows along the nasal dorsum Cleft is medial to the malpositioned medial
canthus
Vertical distopia Telecanthus
2. Bony characteristics:
Keel-shaped maxilla with medially facing teeth Anterior open bite Cleft is between the central and lateral incisors
and into the pyriform aperture, through the primary and secondary palate, and then between nasal bone and maxilla
Flattened nasal bones Ethmoid hypertrophy
D. Number 2 Cleft
1. Soft tissue characteristics:
Cleft lip lies in the region of common clefts Hypoplasia of the mid-alar cartilage Flattened lateral nose Broad nasal dorsum Cleft passes medial to the palpebral fissure Normal lacrimal drainage Laterally displaced medial canthus
2. Bony characteristics:
Cleft between the lateral incisor and canine into the pyriform sinus
Intact maxillary sinus Complete cleft of theprimaryand secondarypalate Intact nasal septum, deviated away from
the cleft
Passes between the nasal bones and maxilla Hypoplastic ethmoid and frontal sinuses Orbital hypertelorism
E. Number 3 Cleft
1. Soft tissue characteristics:
Most common Tessier cleft Cleft is along philtral column into the nasal floor Vertical shortening between the ala and
lower lid
Short nose Upward pull of the alar base Disrupted lacrimal system and lower canaliculus Lower lid colobomas.
