Macrostomia Repair: Comparison of the Z- Plasty Repair with the Straight line Closure

Background: Macrostomia, also called Tesssier 7 or lateral cleft is an uncommon congenital anomaly which results from the failure of fusion of the maxillary and mandibular processes of the first branchial arch. It could be syndromic or isolated, unilateral or bilateral. There is no consensus among surgeons about the single most acceptable method of repair and as such various methods of repair which attempt to restore normal anatomy have been proposed. This article presents the two cases managed at our hospital and compares the two most commonly performed procedures. Case Report: The two patients who presented to the Plastic and Reconstructive Surgery unit of our Hospital, with bilateral macrostomia over a three year period from 1st April 2004 to 31st March 2007 form the basis for the report. One patient had a Z-plasty repair while the second patient had a straight line closure. The outcome of management of the two patients is presented Conclusion: The scar in the patient with the Z-plasty repair appeared more prominent. Both patients however had normal appearing commisures. The multiplicities of options available for the repair of macrostomia suggest that no single method has been found to be most acceptable. The fear of scar contracture in simple line closure appears to be exaggerated