Long-Term Functional and Aesthetic Outcomes of Bilateral Tessier No. 7 Cleft With Associated Anomalies: A Case Report With 20-Year Follow-up

We report the long-term functional and aesthetic outcomes of a male patient with bilateral severe Tessier no. 7 clefts associated with mandibular hypoplasia, cleft palate, right soft-palate hypoplasia, and congenital bilateral facial nerve palsy. The patient required enteral nutrition from birth because oral feeding was impossible. Through staged reconstruction, including oral floor muscle release, bilateral commissuroplasty, palatoplasty, pharyngeal flap surgery, tracheostomy, and later tracheostomy closure, he ultimately achieved full oral intake, phonation, and social adaptation in adulthood. This case highlights the importance of growth-adapted, multidisciplinary, long-term management for patients with severe bilateral Tessier no. 7 clefts.