Distraction Osteogenesis in a Tessier 6 Cleft After Fronto-Orbito-Zygomatic Osteotomy - A Case Report

THE RATIONALE: Craniofacial clefts are rare malformations. According to their localization, 15 types are classified. PATIENT CONCERNS: They referred to impaired eyelid function, lateral protection of the eye-bulb, and aesthetic appearance. DIAGNOSIS: A three-dimensional-computerized tomography scan and a stereolithographic model led to the diagnosis of a rare intraorbital Tessier 6 cleft. TREATMENT: A newly designed lateral orbital rim osteotomy, presurgically simulated on a stereolithographic model, was performed to forward position the lateral orbital rims bilaterally by osteodistraction. OUTCOMES: Both lateral orbital rims were distracted anteriorly for around 12 mm over a period of 9 weeks, without any side effects to the patient. TAKE-AWAY LESSONS: In this intraorbital Tessier 6 cleft, an improved eyelid function with better lateral protection of the eye bulb and more favorable aesthetic appearance was achieved with this novel lateral orbital rim osteotomy.