Prenatal diagnosis of isolated lateral facial cleft by ultrasonography and three-dimensional printing: A case report

Wen-Ling Song; Hai-Ou Ma; Yu Nan; Yu-Jia Li; Na Qi; Li-Ying Zhang; Xin Xu; Yuan-Yi Wang

doi:10.12998/wjcc.v9.i24.7196

Prenatal diagnosis of isolated lateral facial cleft by ultrasonography and three-dimensional printing: A case report

World J Clin Cases. 2021 Aug 26;9(24):7196-7204. doi: 10.12998/wjcc.v9.i24.7196.

Authors

Wen-Ling Song¹, Hai-Ou Ma², Yu Nan², Yu-Jia Li², Na Qi², Li-Ying Zhang², Xin Xu², Yuan-Yi Wang³

Affiliations

¹ Department of Obstetrics, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
² Prenatal Diagnosis Center, The Second Hospital of Jilin University, Changchun 130021, Jilin Province, China.
³ Department of Spine Surgery, The First Hospital of Jilin University, Jilin Engineering Research Center for Spine and Spinal Cord, Changchun 130021, Jilin Province, China. wangyuanyi@jlu.edu.cn.

Abstract

Background: Lateral facial clefts are atypical with a low incidence in the facial cleft spectrum. With the development of ultrasonography (US) prenatal screening, such facial malformations can be detected and diagnosed prenatally rather than at birth. Although three-dimensional US (3DUS) can render the fetus' face via 3D reconstruction, the 3D images are displayed on two-dimensional screens without field depth, which impedes the understanding of untrained individuals. In contrast, a 3D-printed model of the fetus' face helps both parents and doctors develop a more comprehensive understanding of the facial malformation by creating more interactive aspects. Herein, we present an isolated lateral facial cleft case that was diagnosed via US combined with a 3D-printed model.

Case summary: A 31-year-old G2P1 patient presented for routine prenatal screening at the 22^nd wk of gestation. The coronal nostril-lip section of two-dimensional US (2DUS) demonstrated that the fetus' bilateral oral commissures were asymmetrical, and left oral commissure was abnormally wide. The left oblique-coronal section showed a cleft at the left oral commissure which extended to the left cheek. The results of 3DUS confirmed the cleft. Furthermore, we created a model of the fetal face using 3D printing technology, which clearly presented facial malformations. The fetus was diagnosed with a left lateral facial cleft, which was categorized as a No. 7 facial cleft according to the Tessier facial cleft classification. The parents terminated the pregnancy at the 24^th wk of gestation after parental counseling.

Conclusion: In the diagnostic course of the current case, in addition to the traditional application of 2D and 3DUS, we created a 3D-printed model of the fetus, which enhanced diagnostic evidence, benefited the education of junior doctors, improved parental counseling, and had the potential to guide surgical planning.

Keywords: Case report; Facial malformations; Isolated lateral facial cleft; Prenatal diagnosis; Tessier No. 7 facial cleft; Three-dimensional printing; Ultrasonography.

Publication types

Case Reports