Cleft Beyond the Lip and Palate: A Bilateral Tessier Cleft

Oblique facial clefts (Tessier Clefts) are severe orofacial clefts beyond the lip and palate that count among the rare congenital malformations “with an incidence of 1.43 to 4.85 per 100,000 births.”1,2 The Tessier Classification System devised by Paul Tessier in 1976 assigned specific caudo-cranial numbers to clefts involving the “soft tissue and underlying bones of the mouth, maxilla, nose, eyes, and forehead” in relation to the sagittal midline of the face.1,3,4 The midline is designated 0 – 14, and adjacent clefts are numbered 1-13, 2-12 and so on, depending on the location and axis of the malformation. We present a patient with a bilateral Tessier 5 cleft.