Repairing a Facial Cleft by Polyether–Ether–Ketone Implant Combined With Titanium Mesh

The Tessier Number 4 cleft is one of the rarest, most complex craniofacial anomalies that presents difficulties in surgical treatment. In this article, we report a case of simultaneous facial depression, eye displacement, and medial canthus deformity. In this case, the maxillary bony defect was reconstructed using computer-assisted design computer-assisted manufacturing (CAD-CAM) polyether–ether–ketone (PEEK) material, and the orbital floor defect was repaired with AO prefabricated titanium mesh. Additionally, the medial canthus was modified with canthopexy and a single Z-plasty flap. Owing to its relative rarity and varied clinical presentations, no definitive operative methods have been accepted for Tessier No. 4 facial cleft. This study presents the combination of CAD-CAM manufactured PEEK material and titanium mesh as an alternative approach for reconstructing the bony defect of Tessier No. 4 facial clefts. Address correspondence and reprint requests to Zhengkang Li, MD, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China; E-mail: lizhengkang58@hotmail.com Received 16 November, 2017 Accepted 11 March, 2018 This work was supported by the National Natural Science Foundation of China (81501605), the Chenguang Plan of the Shanghai Education Development Foundation (16CG16), and The Science and Technology Commission of Shanghai (17DZ2260100). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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