Macrostomia: a review of evolution of surgical techniques.

Macrostomia is a congenital deformity resulting from failure of fusion of maxillary and mandibular process. It is a rare congenital deformity with an incidence of 1 in 60,000 to 1 in 300,000 live births. Transverse facial clefts are more common on right side of face in unilateral cases. Males are more affected than females. Various surgical techniques have been described in the literature for the correction of these defects. We report a case of macrostomia corrected with Z-plasty closure for skin, overlapping muscle closure, and triangular mucosal flap for commissure, with a review on existing techniques.

Nonsyndromic mandibular symphysis cleft.

Median cleft of lower lip and mandible is a rare congenital anomaly described as cleft number 30 of Tessier's classification. In minor forms only lower lip cleft is seen. We report the case of a patient with median cleft of lower lip, severe ankyloglossia, cleft of mandibular symphysis, and residual cleft involving on right soft palate and associated with other facial clefts. These deformities were corrected in multiple stage procedure, consisting of release of the tongue from floor of the mouth and lower alveolus and fixation of the mandibular cleft done with right iliac bone graft using stainless steel miniplate.

Nonsyndromic facial asymmetry with unilateral condylar aplasia.

Introduction. The temporomandibular joint (TMJ) is the most complex elegantly designed joint in the human body. Abnormal development and growth of TMJ may lead to condyle aplasia present in several syndromes expressions, but it is extremely rare when not connected to any underlying pathological disorder or in conjunction with any syndrome. Objective. A rare case of aplasia of the mandibular condyle is presented, along with 3D computed tomography (3D CT) findings. Conclusion. Based on clinical and radiological findings we suggest the abnormal development of the TMJ as the origin. The 3D CT has provided high-quality images, which made diagnosis and a prompt treatment plan possible.

Supraorbital blowin fracture presenting as an ocular dystopia in a nine-year-old girl.

A 9-year-old girl was referred to a trauma centre with severe head injury. 3D CT scan revealed depressed fracture involving the frontal bone on the right side, right parietal bone, and right superior orbital margin, right lamina papyracea. The frontal table was managed conservatively and open reduction and internal fixation was done for the supraorbital blow in to correct the ocular dystopia. The clinical course, possible mechanism, and management of the patient are discussed.