Lateral facial clefts: closure with W-plasty and implications of speech and language development.

Lateral facial clefts are rare; their incidence is about 1 in 60,000 births. Early treatment with closure in layers is stressed. The mucosa is closed in with a Z-plasty to avoid intraoral band contracture, the orbicularis muscle is closed after interfiber reorientation, and the skin is closed with W-plasty to produce a more aesthetic result and avoid the fissure-like appearance. A familial incidence is noted. Language development is observed before and after the surgical corrective procedure.