{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:31:15Z","timestamp":1777523475165,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:p>The Tessier no. 5 facial cleft is an extremely rare congenital malformation. Only 26 cases have been described in the English-language literature. The cleft begins in the upper lip just medial to the oral commissure, extending across the cheek as a groove ending at the junction of the middle and lateral thirds of the lower eyelid. The bone involvement usually includes an alveolar cleft in the premolar region, extends across the maxilla lateral to the infraorbital nerve, up to the infraorbital rim and orbital floor. The goals of the surgical procedure include reconstructing the lower eyelid, repositioning the lateral canthus, closure of the labiomaxillary cleft, and restoration of the skeletal continuity (including the orbital floor defect) with bone grafts. We present six patients with the Tessier no. 5 facial cleft who have been treated in our combined centers and discuss the surgical options and difficulties faced in the reconstruction of this rare and challenging craniofacial malformation. To date, we have treated six patients (two with bilateral and four with unilateral clefts). Three of the patients with unilateral clefting had an associated no. 4 cleft and one patient with a bilateral cleft had an associated no. 3 cleft. This paper represents the largest series to date documenting surgery for patients with the Tessier no. 5 facial cleft.<\/jats:p>","DOI":"10.1597\/07-192.1","type":"journal-article","created":{"date-parts":[[2009,3,2]],"date-time":"2009-03-02T11:33:38Z","timestamp":1235993618000},"page":"179-186","source":"Crossref","is-referenced-by-count":34,"title":["The Tessier Number 5 Facial Cleft: Surgical Strategies and Outcomes in Six Patients"],"prefix":"10.1177","volume":"46","author":[{"given":"Renato","family":"da Silva Freitas","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery, Federal University of Paran\u00e1, Grandar, Curitiba Brazil;"},{"name":"Center for Cleft Lip and Palate (CAIF), Curitiba, Brazil;"},{"name":"Yale Craniofacial Center, New Haven, Connecticut."}]},{"given":"Nivaldo","family":"Alonso","sequence":"additional","affiliation":[{"name":"Craniofacial Surgery Unit, Section of Plastic Surgery, S\u00e3o Paulo University, S\u00e3o Paulo, Brazil."}]},{"given":"Joseph H.","family":"Shin","sequence":"additional","affiliation":[{"name":"Yale Craniofacial Center, Section of Plastic Surgery, Yale University School of Medicine, New Haven, Connecticut."}]},{"given":"Luciano","family":"Busato","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Unit, Federal University of Paran\u00e1, Grandar, Curitiba, Brazil."}]},{"given":"Andr\u00e9Ricardo","family":"Dall'Oglio Tolazzi","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Unit, Federal University of Paran\u00e1, Grandar, Curitiba, Brazil."}]},{"given":"Gilvani Azor","family":"de Oliveria e Cruz","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1, Grandar, Curitiba, Brazil."}]}],"member":"179","published-online":{"date-parts":[[2009,3,1]]},"reference":[{"key":"bibr1-07-192.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(70)80074-1"},{"key":"bibr2-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000240818.64018.2a"},{"key":"bibr3-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198903000-00022"},{"key":"bibr4-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000164494.45986.91"},{"key":"bibr5-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199107000-00023"},{"key":"bibr6-07-192.1","first-page":"23","volume":"15","author":"Johnston M.C.","year":"1979","journal-title":"Birth Defects Orig Artic Ser."},{"key":"bibr7-07-192.1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(2001)038<0529:TTNCWA>2.0.CO;2"},{"key":"bibr8-07-192.1","first-page":"518","volume":"45","author":"Karfik V.","year":"1966","journal-title":"Rozhl Chir."},{"key":"bibr9-07-192.1","first-page":"529","volume":"3","author":"Kawamoto H.K.","year":"1976","journal-title":"Clin Plast Surg."},{"key":"bibr10-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199903000-00003"},{"key":"bibr11-07-192.1","first-page":"245","volume":"35","author":"Morian R.","year":"1887","journal-title":"Arch Klin Chir."},{"key":"bibr12-07-192.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.02.006"},{"key":"bibr13-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-199711000-00006"},{"key":"bibr14-07-192.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0503(76)80013-6"},{"key":"bibr15-07-192.1","first-page":"149","volume-title":"Plastic Surgery of the Orbit and the Eyelids.","author":"Tessier P.","year":"1977"},{"key":"bibr16-07-192.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198508000-00007"},{"key":"bibr17-07-192.1","first-page":"315","volume":"35","author":"Warkany J.","year":"1959","journal-title":"Am J Pathol."}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1597\/07-192.1","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1597\/07-192.1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:21:03Z","timestamp":1777393263000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1597\/07-192.1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,3]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2009,3]]}},"alternative-id":["10.1597\/07-192.1"],"URL":"https:\/\/doi.org\/10.1597\/07-192.1","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,3]]}}}