Clinical Features of a Patient with Bilateral Cleft Lip and Alveolus Associated with Bilateral Tessier No. 7 Clefts and Accessory Maxillae:A 15-Year Follow-up

We summarize the clinical history and features of a patient with bilateral facial clefts (Tessier no. 7) and accessory maxillae.
A male patient exhibited bilateral cleft lip and alveolus combined with bilateral transverse facial clefts at birth. The maxilla was hyperplastic in contrast to the markedly hypoplastic mandible; the right and left ears had mild and severe conductive deafness, respectively. Accessory maxillae were located on both sides of the maxilla: two on the right and one on the left. Noncraniofacial associations were observed. Bilateral cleft lip and transverse facial clefts were repaired when he was 5 and 9 months old, respectively. At growth completion, intra-oral examination revealed prolonged retention of deciduous teeth, with a large overjet and severe anterior open bite. Computed tomography demonstrated that the accessory maxillae carried extra sets of teeth and were attached to the inferior border of the zygoma or zygomatic arch on both sides. The left mandibular ramus and condyle were hypoplastic compared with those on the right side, and the left mandibular coronoid process was absent.
Comprehensive treatment, including orthognathic surgery, orthodontics, and prosthodontics, is required for improvement of his quality of life.