{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:42:09Z","timestamp":1742197329198,"version":"3.38.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Padjadjaran"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Maxillofac Plast Reconstr Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Craniofacial anomalies, particularly Tessier facial clefts, present significant surgical and functional challenges. Bilateral Tessier 3 and Tessier 0 clefts are extremely rare, often requiring complex reconstructive strategies. These clefts result in severe nasal deformities, including absent nasal septum, hypertelorism, and malpositioned alae nasi, affecting both appearance and function. Due to the lack of standardized approaches in such cases, this report highlights a staged surgical reconstruction aimed at restoring nasal structure and improving facial harmony, with a 12-month follow-up showing stable nasal contour and functional airway restoration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 16-year-old female presented with bilateral Tessier 3 and Tessier 0 clefts, exhibiting hypertelorism, a wide nasal dorsum, cranial displacement of the alae nasi, and an absent nasal septum. The patient underwent staged reconstruction. The first stage repositioned the alae nasi and created a functional nasal airway. In the second stage, costal cartilage was used to construct an L-shaped septal extension graft and dorsal onlay graft to restore nasal contour and stability. A subsequent procedure refined the nasal dorsum and approximated the alae nasi. Although orbital box osteotomy was planned to correct hypertelorism, the patient declined further intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This case highlights the effectiveness of a staged reconstructive approach in addressing rare craniofacial anomalies. Twelve-month postoperative follow-up confirmed the stability of nasal contour, functional airway patency, and satisfactory facial symmetry. The decision to forgo orbital box osteotomy emphasizes the role of patient-centered care in craniofacial surgery. This case provides valuable insights for optimizing reconstructive techniques in complex facial clefts.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40902-025-00461-0","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:13:32Z","timestamp":1742195612000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges in nasal reconstruction for facial clefts Tessier 3 bilateral and Tessier 0: a staged surgical approach case report"],"prefix":"10.1186","volume":"47","author":[{"given":"Arif Tri","family":"Prasetyo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"issue":"4","key":"461_CR1","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1007\/s12663-023-01903-w","volume":"22","author":"H Soedjana","year":"2023","unstructured":"Soedjana H, Prasetyo AT, Mayrissa TF, Andalu N (2023) Neglected case of facial cleft associated with Adam complex: soft tissue reconstruction with abbe flap and nasal transposition\u2014a case report. J Maxillofac Oral Surg 22(4):966\u201371","journal-title":"J Maxillofac Oral Surg"},{"key":"461_CR2","doi-asserted-by":"publisher","first-page":"106432","DOI":"10.1016\/j.ijscr.2021.106432","volume":"87","author":"H Soedjana","year":"2021","unstructured":"Soedjana H, Prasetyo AT, Dewi C (2021) Paranasal transposition flap in facial soft tissue reconstruction of facial cleft Tessier type 3 & ADAM complex: a case report. Int J Surg Case Rep 87:106432","journal-title":"Int J Surg Case Rep"},{"key":"461_CR3","doi-asserted-by":"publisher","first-page":"109708","DOI":"10.1016\/j.ijscr.2024.109708","volume":"119","author":"H Soedjana","year":"2024","unstructured":"Soedjana H, Hasibuan LY, Prasetyo AT, Suryadinata KL (2024) Surgical reconstruction of the external nose: alar rotational and hinged flap techniques for facial cleft Tessier 0\u20131 with lipoma on dorsal nasal region\u2014a case report. Int J Surg Case Rep 119:109708","journal-title":"Int J Surg Case Rep"},{"key":"461_CR4","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/S0301-0503(76)80013-6","volume":"4","author":"P Tessier","year":"1976","unstructured":"Tessier P (1976) Anatomical classification of facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 4:69\u201392","journal-title":"J Maxillofac Surg"},{"issue":"4","key":"461_CR5","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1097\/MOO.0000000000000985","volume":"32","author":"AM Civantos","year":"2024","unstructured":"Civantos AM, Shakya P, Shaye DA (2024) Atypical facial clefts: Tessier number 3 and 4 clefts. Curr Opin Otolaryngol Head Neck Surg 32(4):248\u201356","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"461_CR6","first-page":"269","volume-title":"Grabb and Smith\u2019s Plastic Surgery","author":"KM Termanini","year":"2025","unstructured":"Termanini KM, Gosain AK (2025) Craniofacial cleft and orbital hypertelorism. In: Chung KC (ed) Grabb and Smith\u2019s Plastic Surgery, 9th edn. Michigan, Wolters Kluwer, pp 269\u201384","edition":"9"},{"issue":"1","key":"461_CR7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s40902-018-0147-3","volume":"40","author":"JH Oh","year":"2018","unstructured":"Oh JH, Park YW (2018) Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement. Maxillofac Plast Reconstr Surg 40(1):9","journal-title":"Maxillofac Plast Reconstr Surg"},{"key":"461_CR8","doi-asserted-by":"crossref","unstructured":"Wang X, Wang H, You J, Zheng R, Xu Y and Fan F (2022) Craniofacial development in patients of Tessier No.0 cleft with a bifid nose using 3D computed tomography. Front Pediatr 10:979345","DOI":"10.3389\/fped.2022.979345"},{"issue":"2","key":"461_CR9","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s12663-009-0043-6","volume":"8","author":"A Jhamb","year":"2009","unstructured":"Jhamb A, Mohanty S (2009) A chronicle of Tessier no. 0 and 1 facial cleft and its surgical management. J Maxillofac Oral Surg 8(2):178\u201380","journal-title":"J Maxillofac Oral Surg"},{"issue":"8","key":"461_CR10","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1177\/1055665620926346","volume":"57","author":"MI Hamzan","year":"2020","unstructured":"Hamzan MI, Sulaiman WAW (2020) True median cleft lip\u201415 years of review and prevalence. Cleft Palate Craniofac J 57(8):1051\u20134","journal-title":"Cleft Palate Craniofac J"},{"key":"461_CR11","doi-asserted-by":"crossref","unstructured":"Grosu-Bularda A, Manea C, Lazarescu L, Lascar I (2016) The role of cartilage and bone allografts in nasal reconstruction. Rom J Rhinol 6(22):75\u201382","DOI":"10.1515\/rjr-2016-0009"},{"issue":"5","key":"461_CR12","doi-asserted-by":"publisher","first-page":"4111","DOI":"10.1007\/s12070-024-04795-5","volume":"76","author":"P Pradhan","year":"2024","unstructured":"Pradhan P, Kharwanlang M (2024) L-strut cartilage graft: a versatile graft in functional rhinoplasty. Indian J Otolaryngol Head Neck Surg 76(5):4111\u20138","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"461_CR13","doi-asserted-by":"crossref","unstructured":"Wang X, Wang H, You J, Zheng R, Xu Y, Zhang X, Guo J and Fan F (2021) Morphological Analysis of Nose in Patients of Tessier No. 0 Cleft With a Bifid Nose in China. Front Pediatr 9:768176","DOI":"10.3389\/fped.2021.768176"},{"issue":"1","key":"461_CR14","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/2024.10.FOCUS24573","volume":"58","author":"K As'adi","year":"2025","unstructured":"As\u2019adi K, Ahmadi S, Mirsalehi M (2025) Surgical treatment of craniofacial cleft and orbital hypertelorism: a single-center cohort study. Neurosurg Focus 58(1):E4","journal-title":"Neurosurg Focus"},{"issue":"2","key":"461_CR15","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1097\/SCS.0000000000009046","volume":"34","author":"L Ouyang","year":"2023","unstructured":"Ouyang L, Li B, Xu S, Jin Q, Chen Y, Gui L et al (2023) Reconstructive operation of severe orbital hypertelorism with computer-assisted precise virtual plan. J Craniofac Surg 34(2):511\u20134","journal-title":"J Craniofac Surg"}],"container-title":["Maxillofacial Plastic and Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40902-025-00461-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40902-025-00461-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40902-025-00461-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:13:40Z","timestamp":1742195620000},"score":1,"resource":{"primary":{"URL":"https:\/\/jkamprs.springeropen.com\/articles\/10.1186\/s40902-025-00461-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["461"],"URL":"https:\/\/doi.org\/10.1186\/s40902-025-00461-0","relation":{},"ISSN":["2288-8586"],"issn-type":[{"value":"2288-8586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"8 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7"}}