{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:41:33Z","timestamp":1793716893737,"version":"4.6.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100005809","name":"Hyderabad Eye Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To discuss the various lacrimal drainage system (LDS) anomalies in patients presenting with Tessier clefts 3 and 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, interventional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary Dacryology center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants, Interventions, and Main Outcome Measures<\/jats:title>\n                    <jats:p>Retrospective, interventional study of all patients presenting with Tessier clefts 3 and 4 with LDS anomalies over a study period of 14 years (January 2011-January 2025). Demographic details, including the age, sex, type of Tessier cleft, laterality, and lacrimal drainage anomalies, were noted. Interventions and the outcomes were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 29 eyes of 17 patients with Tessier cleft number 3 and 4 deformities were included in the study. Seven patients had Tessier cleft number 3 deformity, and 10 patients had Tessier cleft number 4 deformity. Males were more affected than the females (11:6). The average age of the patients at presentation was 9.94 years (range: 3-39 years). Twelve eyes of 7 patients presented with Tessier cleft number 3 deformity, and 17 eyes of 10 patients had Tessier cleft number 4 deformity. Tessier cleft number 3 showed more common involvement of proximal LDS, while Tessier cleft number 4 involved both the proximal and distal LDS frequently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tessier clefts 3 and 4 can be associated with varied proximal and distal LDS anomalies. Management is challenging and needs an individualized treatment approach depending on the symptomatology and the part of the LDS involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Precis<\/jats:title>\n                    <jats:p>Tessier cleft numbers 3 and 4 involve the LDS in its path, causing varying damage to the different parts of the system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261442689","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:05:48Z","timestamp":1776261948000},"page":"4335-4341","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lacrimal Drainage System Anomalies in Patients With Tessier Clefts 3 and 4"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-9445","authenticated-orcid":false,"given":"Nandini","family":"Bothra","sequence":"first","affiliation":[{"name":"L.V. Prasad Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Bhopatkar","sequence":"additional","affiliation":[{"name":"L.V. Prasad Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Javed","family":"Ali","sequence":"additional","affiliation":[{"name":"L.V. Prasad Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0503(76)80013-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(90)90014-Q"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119891475"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181cfa6b1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000011373"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2011.12.007"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0503(74)80017-2"},{"key":"e_1_3_2_9_2","unstructured":"Duke-Elder S. Normal and abnormal development congenital deformities. In: System of ophthal. Vol. 3 part I 241 part II 924. 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