Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2021; 9(24): 7196-7204
Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7196
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
Wen-Ling Song, Department of Obstetrics, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Hai-Ou Ma, Yu Nan, Yu-Jia Li, Na Qi, Li-Ying Zhang, Xin Xu, Prenatal Diagnosis Center, The Second Hospital of Jilin University, Changchun 130021, Jilin Province, China
Yuan-Yi Wang, Department of Spine Surgery, The First Hospital of Jilin University, Jilin Engineering Research Center for Spine and Spinal Cord, Changchun 130021, Jilin Province, China
Author contributions: Song WL and Wang YY conceptualized the study and printed the model; Wang YY drafted the manuscript; Song WL and Ma HO performed the US; Wang YY and Nan Y reviewed the literature; Li YJ, Qi N, Zhang LY, and Xu X performed the induction.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare no competing interests for this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yi Wang, MD, PhD, Associate Professor, Department of Spine Surgery, The First Hospital of Jilin University, Jilin Engineering Research Center for Spine and Spinal Cord, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. wangyuanyi@jlu.edu.cn
Received: February 23, 2021
Peer-review started: February 23, 2021
First decision: June 15, 2021
Revised: June 17, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: August 26, 2021
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 22nd 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 24th 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: Prenatal diagnosis, Isolated lateral facial cleft, Three-dimensional printing, Facial malformations, Ultrasonography, Tessier No. 7 facial cleft, Case report

Core Tip: In this study, we present a case with rare facial anomaly of isolated lateral facial cleft. In the prenatal diagnostic course, in addition to the traditional screening using two-dimensional and three-dimensional (3D) ultrasonography, 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.