Tessier cleft type 5 craniofacial anomaly – A rare oblique facial cleft

One of the rarest types of craniofacial malformations is Tessier cleft type 5. These are oblique facial clefts with bony defect representing an alveolar cleft in the premolar region. This extends to the lateral surface of the maxilla up to the infraorbital rim and orbital floor. The cleft begins in the upper lip, just medial to the commissure, and extends up to the eyelid. They may also show deficient maxillary growth on the side of the cleft, clinically represented as constriction in the maxilla and occlusal cant. It becomes very challenging to treat such cases and requires a team approach. The goals of such cases include surgical repair of the lower eyelid and outer canthus, expansion of the arch and alignment, Bone grafting for the alveolar cleft, zygomatic region, and orbital rim to restore the continuity. The following is a case report of Tessier type 5 facial cleft describing the clinical features, diagnosis, and treatment approach for the case.