This particular case is of a 23 year old
man with a rare complex congenital cranio-facial cleft
involving the maxilla (upper jaw), nose (including the
bony nasal cavity) and nasal septum, upper lip and both
orbits (eye sockets).
The abnormal anatomy is difficult to understand
by a physical examination as there is gross absence,
displacement or hypoplasia (stunted growth) of a variety
of tissues in a 3dimensional field, especially the central
third of the face (nose and nasal cavity). The anomalies
of the skeleton are important to understand pre-operatively
as pre-surgical planing will be of paramount importance
in this case. The smallest surprise faced suddenly at
the time of operation could be the difference between
success and failure; between correction of this ghastly
disfigurement and its continuance.