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Summary: Introduction: The orofacial clefts include 30 variant according to Tessier classification: the number 30 contain mandibular arc damage isolated or associated with damage of surrounding soft tissue. Case report: Our patient was a newborn with median mandibular cleft associated with ankyloglossia, bifid tongue and a top cervical fistula. We have not found polymalformative syndrome. The early surgical management included one time and after-effect were simple within 11months. Discussion: We point up difficulties for antenatal diagnosis and controversy about appropriate time for management of bone defect. The last physiopathologic hypotheses were explicated. [ABSTRACT FROM AUTHOR]