Patterns of Cleft Lip and Cleft Palate in Southern Pakistani Population

2021 ◽  
Vol 15 (8) ◽  
pp. 2089-2092
Author(s):  
Muhammad Anwar ◽  
Gulam Mustafa ◽  
Zishan Haider

Objectives: To determine various types of cleft lip and palate, its geographical distribution and its association with cousin marriages, family history and other craniofacial syndromes in the Southern Pakistani population. Study design: Cross-sectional study Place and Duration of Study: Plastic Surgery Department of Sheikh Zayed Medical College / Hospital, Rahim Yar Khan and Hamza Medicare, Rahim Yar Khan from January 2020 to March 2021. Methodology: All patients who presented to the outpatients department with cleft deformities of lip and palate, irrespective of their age and gender were included in the study. Patients who were operated previously and those who were not agree with the study protocol were excluded from the study. The data were collected through a structured proforma as well as history and physical examination. The data were organized and analyzed through Statistical Package for Social Sciences version 23. Results: Total of 403 patients with cleft lip and palate deformities were included in this study, with an average age of 39±62 months. Out of total 239 59.3% were males with male to females ratio of 1.4:1. Cleft lip with cleft palate, cleft palate only and isolated cleft lip were found in 56.8%, 13.4% and 29.20% of cases respectively and 2 (0.5%) cases of median cleft. Out of total, 155 (38.5%) were from Southern Punjab, 50.6% from Sindh and 10.9% were from Baluchistan Province. In 386 (95.8%) cases parent had a History of cousin marriage, and family history of Cleft Lip & Cleft Palate was positive in 67 (16.6%) cases. Other congenital anomalies were found in 12.5% of cases. Conclusion: Cleft lip and palate deformities affected the male population more than females. Cleft lip in association with cleft palate is the commonest deformity. Isolated cleft palate mainly affected females. The high incidence of these anomalies in cousin marriages emphasizes educating the people to avoid cousin marriages. Key Words: Cleft Lip, Cleft Palate, Consanguinity, Family history. Congenital deformities

2008 ◽  
Vol 45 (6) ◽  
pp. 597-602 ◽  
Author(s):  
Somchit Jaruratanasirikul ◽  
Vichai Chichareon ◽  
Nuria Pattanapreechawong ◽  
Pasuree Sangsupavanich

Objective: To study the clinical characteristics, demographic data, and associated congenital anomalies of pediatric patients with cleft lip and/or palate in Southern Thailand. Design: Retrospective, hospital-based study. Setting: Cleft Clinic Center, Songklanagarind Hospital Participants: Children with cleft lip and/or palate who were born or seen at Songklanagarind Hospital between January 1997 and December 2006. Main Outcome Measure: Clinical features including demographic data, types of cleft, associated anomalies, family history of clefts, and physical growth. Results: A total of 153 children were seen during the studied period, of whom 36 (23.5%) had isolated cleft lip, 32 (20.9%) had isolated cleft palate, and 85 (55.6%) had combined cleft lip and palate. Twenty-seven children (17.7%) had a family history of clefts. Congenital malformations (syndromic cleft) were found in 20 children (13%), and chromosomal abnormalities were found in four of these (20%). There were no significant differences among the three groups (isolated cleft lip, isolated cleft palate, and combined cleft lip and palate) in maternal and paternal ages, gestational age, birth weight, family history of cleft, or associated malformations. The physical growth parameters of children with nonsyndromic cleft were the same as in the general population. Children with syndromic cleft were significantly lighter at birth and had grown up significantly shorter and lighter, with smaller head circumference. Conclusions: Chromosomal abnormalities are commonly found in children with syndromic cleft. Children with nonsyndromic cleft have normal growth; whereas, those with syndromic cleft have some degree of prenatal and postnatal growth restriction.


1992 ◽  
Vol 29 (5) ◽  
pp. 470-474 ◽  
Author(s):  
Bente Felix-Schollaart ◽  
Jan B. Hoeksma ◽  
Jean Paul Van De Velde ◽  
Jerôme I. Puyenbroek ◽  
Birte Prahl-Andersen

The reproductive history was studied to evaluate if the three types of solitary, nonsyndromic clefts: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP) are homogeneous entities. Occurrence of fetal loss, maternal health, and drug consumption of the mother during the pregnancy were compared in cases involving three types of clefts. Data was gathered from 87 children with clefts, 55 males and 32 females. Spontaneous abortions and vaginal bleeding were found to occur significantly more often in the (older) mother of a CLP child. This suggests that the factors involved in the etiology of CLP differ from the factors involved in CL and CP. Therefore, grouping of data of the three types of clefts in studies on the etiology should be avoided.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
P. Agbenorku ◽  
M. Yore ◽  
K. A. Danso ◽  
C. Turpin

Background. Cleft lip and cleft palate are among the most common orofacial congenital anomalies. This study is to establish Orofacial Clefts Database for Kumasi, Ghana, with a view to extend it to other cities in future to obtain a national orofacial anomaly database. Methods. A descriptive prospective survey was carried out at eleven selected health facilities in Kumasi. Results. The total number of live births recorded was 27,449. Orofacial anomalies recorded were 36, giving an incidence of 1.31/1000 live births or 1 in 763 live births. The mean maternal age of cleft lip/palate babies was 29.85 years (range 18–40 years). The male : female ratio for the orofacial anomalies babies was 1.3 : 1; the male : female ratio was 0.5 : 1 in the cleft lip group, 1.3 : 1 in the cleft lip and palate group, and 4 : 1 in the cleft palate group. The majority of clefts were unilateral (69.4%, n=25), with females (n=14) outnumbering males (n=11). A family history of cleft was recorded with five babies (13.9%). Associated congenital anomalies were recorded in seven (19.4%) cleft lips and/or palates. Conclusion. The incidence of 1 in 763 live births found in this study indicates that cleft lip/palate is a common congenital anomaly in Kumasi.


2016 ◽  
Vol 23 (05) ◽  
pp. 516-521
Author(s):  
Tajammal Abbas Shah

A prospective study was conducted to look for prevalence of cleft lip and palate ina population presenting to a surgical unit in a teaching hospital. Objectives: To see prevalenceof cleft lip and palate alone, lip and palate combined, right or left sided, male to femaledistribution, and possible factors responsible for clefting. Study Design: A prospective study.Setting: Surgical Unit II at Allied Hospital Faisalabad. Period: March 2009 to March 2010 forone year. Materials and Methods: Total 55 patients were treated in year 2009 out of total17900 (0.3 %) patients admitted in all surgical wards and 6508 patients admitted in surgicalunit II (0.8%). Patients were divided into three groups, cleft lip alone (group A), cleft palatealone (group B) and combined cleft lip and palate (group C). Children up to the age of 5 yearswith congenital abnormality were included in study. Results: Out of 6508 patients admitted insurgical unit II 55 patients (0.8%) had cleft lip and palate defect. 55 patients were divided inthree groups. In group A, 32 patients presented with cleft lip alone ( 58.1 % ), 16 ( 29 % ) weremales and 16 ( 29 % ) were females, 21 patients have left sided ( 38 % ), 4 right sided (7.27% )and 7 patients have bilateral ( 12.72 % ) defects. 2 patients (3.63 %) had family history of cleft lipand both were males. In group B, 12 patients ( 21.8 %) had cleft palate alone, 7 patients ( 12.72% ) were males and 5 patients ( 9 % ) were females, 10 patients ( 1.18 % ) had soft palate onlywhile 2 patients ( 3.63 % ) had compete ( hard and soft ) palatal defect. In group C, 11 patients,had cleft lip and palate combined ( 20 % ), 6 patients were males ( 10.9 % ) and 5 patients ( 9% ) were females, 8 patients ( 14.54 % ) had only soft palate defect while 3 patients ( 5.45 % )had complete palatal defect associated with 8 patients ( 14.54 % ) left sided unilateral lip defectand 3 patients ( 5.45% ) had bilateral cleft lip. All patients were operated without any mortality.Ages of mothers at earliest were 16 and 18 years, 3 cousin marriages, ( 5.45 % ) all fathers weresmokers, belonged to poor socio economic families and no history of mother’s exposure toradiation, drug abuse during gestational life. Conclusion: As it is obvious from this study thatall patients belongs to poor socio economics group, and all fathers were smokers, 3 patientsborn in parents who had cousin marriages ( 5.45 % ) 2 patients ( 3.63 % ) with family history,cleft lip and palate are multifactorial congenital abnormalities, runs in families and is influencedby various environmental factors.


2019 ◽  
Vol 4 (1) ◽  
pp. 621-624
Author(s):  
Sanjeev Kumar Thakur ◽  
Baleshwar Yadav ◽  
Raj Kumar Bedajit ◽  
Kailash Khaki Shrestha ◽  
Shankar Man Rai

Introduction: Cleft lip and palate is one of the most common congenital anomaly, which contributes to eustachian tube dysfunction leading to impaired middle ear ventilation and middle ear pathology. It has been stated that the timely repair of cleft palate reduces the incidence of otitis media with effusion. Objective: To describe the ear findings in cleft palate patients who have undergone repair of cleft palate. Methodology: A total of 36 (20 male and 16 female) post cleft repair patients underwent Otoscopy and Tympanometry between January to December 2018. Cases with isolated cleft lip, ears with perforation of tympanic membrane and attico-antral disease were excluded. Results: The age range was from 4 years to 24 years, with a mean of 11.34 years. Maximum patients were of the age group of 10- 20 years (18, 50%) followed by that of 5-10 years range (15, 41.66%). Total number of ears examined were 72. Out of a total of 72 ears, 70 (97.2%) had abnormal otoscopic finding with dull tympanic membrane in 37 (51.39%) ears, retracted in 31 (43.05%) and bulging tympanic membrane in 2 (2.78%) cases. Type B curve was the commonest (36, 50%), followed by Type As (24, 33.3%). Type C curve was found in 11(15.3%) ears. Type A curve was found only in one ear. The duration of post-repair of cleft palate ranged from 6 months to up to 16 years with a mean of 8.52; 11 cases(30.56%) had history of repair of cleft palate of more than 10 years duration.16 cases (44.44%) had that of more than 5 years and 9 cases (25%) had less than 5 years history of duration of repair. When correlation was done statistically, the tympanometry findings and duration of repair had a very low correlation (Table 5). The time period of repair had no significant effect on tympanometric ear findings. Conclusion Abnormal otoscopic findings and tympanometric findings were common in post cleft palate repaired patients. The duration of cleft palate repair had low correlation to the tympanometric ear findings.


2017 ◽  
Vol 10 (4) ◽  
pp. 335-338 ◽  
Author(s):  
Rungnapa Ittiwut ◽  
Pichit Siriwan ◽  
Kanya Suphapeetiporn ◽  
Vorasuk Shotelersuk

Abstract Background Oral clefts, including cleft lip (CL), CL with cleft palate (CL/CP), and cleft palate only (CPO), are among the most common birth defects, and if left untreated can cause significant morbidity. Causes are complex and involve both genetic and environmental factors. Several studies have demonstrated the highest prevalence of oral clefts being in Asian, white, and African populations. However, there have been very few epidemiological studies of oral clefts in Thais. Objectives To describe the epidemiology and factors associated with oral clefts in Thais. Methods This retrospective case-control observational study included individuals from numerous regions in Thailand. We reviewed data regarding 784 patients with an oral cleft collected in questionnaires as part of the Thai nationwide Smart Smile and Speech Project from 2006 to 2014. Data regarding patients with oral clefts were analyzed, and compared with data regarding 187 unaffected controls. Results Of 784 cases, CL/CP accounted for 59.8%, CPO 21.9%, and CL 18.3%. A family history of oral clefts was detected in all 3 types (P < 0.001). Maternal use of any drugs or herbal medicine not prescribed by physicians during pregnancy in cases of CPO (P = 0.049) and maternal consumption of alcohol during pregnancy in cases of CL/CP (P = 0.047) were significantly higher than that by mothers of controls. Conclusions CL/CP is the most common type of oral cleft. A family history of oral clefts, and maternal consumption of alcohol or nonprescribed drugs are positively associated with oral clefts in Thais.


2009 ◽  
Vol 46 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Wei Zheng ◽  
James D. Smith ◽  
Bing Shi ◽  
Yu Li ◽  
Yan Wang ◽  
...  

Objective: To present the tympanometric findings in 552 patients (115 over 10 years of age) with unrepaired cleft palate (256 had audiologic findings) and to show the natural history and outcome of these cases. Setting: The cleft lip and palate clinic for the Division of Cleft Lip and Palate Surgery at the West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China. Design: Pure-tone audiometric and tympanometric evaluations were performed on 552 patients with an unrepaired cleft palate. Results were analyzed by looking at the patient's age and cleft palate type. Results: This study demonstrated an age-related decrease in the frequency of hearing impairment and abnormal tympanometry. The frequency of hearing impairment and abnormal tympanometry in patients with submucous cleft palate was significantly lower than in patients from the other four major cleft palate categories (p  =  .001, p  =  .006, respectively). Conclusions: The middle ear function and hearing levels of unrepaired cleft palate patients improved with age, but at least 30% of the patients’ ears demonstrated a hearing loss and abnormal tympanometry in each age group, including those over 19 years of age. In the crucial language-learning stage, the frequency of hearing impairment and abnormal tympanometry was as high as 60%. Considering these results, palate repair and surgical intervention, such as tube insertion, for otological problems should be considered at an early age.


2007 ◽  
Vol 44 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Ann W. Kummer ◽  
Linda Lee ◽  
Lindsay Schaadt Stutz ◽  
Adam Maroney ◽  
Jennifer Weidenbach Brandt

Objective: The purpose of this study was to assess the oral-motor function of children with a history of cleft lip and palate, cleft palate only, velocardiofacial syndrome, and children with normal oral structures to determine if children with velocardiofacial syndrome have more apraxia characteristics than the other populations have. Design: The Apraxia Profile (Hickman, 1997) was administered to all participants in a prospective study. Setting: The investigation was conducted at Cincinnati Children's Hospital Medical Center. Participants: In this study, 10 children with cleft lip and palate, 10 with cleft palate only, 7 with velocardiofacial syndrome, and 47 with normal structures were tested. Results: This study revealed that when compared with children with normal structures, children with cleft lip and palate did not demonstrate significant apraxia characteristics, children with cleft palate only demonstrated some apraxia characteristics, and children with velocardiofacial syndrome demonstrated the most apraxia characteristics. Conclusions: There appears to be a high prevalence of apraxia characteristics in the speech of patients with velocardiofacial syndrome. This information has implications for the type of treatment recommended. Further investigation is warranted with a larger patient population and a focus on the association of abnormal brain structure with apraxia in this population.


2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1027-1031
Author(s):  
Joshini Shanmugam ◽  
Senthil Murugan P ◽  
Suresh V

Consanguinity is considered a significant factor in autosomal recessive diseases; it has also been associated with congenital anomalies such as hydrocephalus, polydactilia and Cleft Lip and Palate deformities. The risk of congenital conditions is higher in subjects born of first degree consanguineous parents compared with those of non-consanguineous marriages. The aim of this study is to evaluate the prevalence of consanguinity with formation of cleft lip/ cleft palate formation in Tamil, Telugu population. This is a retrospective study. The details of 86,000 patient records were reviewed and analysed, out of which 76 patients who had undergone surgical treatment for cleft lip and cleft palate deformities between June 2019 to march 2020 were included in this study. The details like age, gender, family history and cleft diagnosis were evaluated and entered in SPSS and analysed through a chi-square test. It was observed that 11% of patients reported with history of consanguineous marriages which was associated with formation of cleft lip/palate. Within the limits of the study, it was concluded that consanguinity had a significant role in formation of cleft lip/cleft palate.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, family history, genetics, recurrence risk, and epidemiology of isolated and syndromic cleft lip with or without cleft palate. Microforms of cleft lip are described. The distinctive anatomy of bilateral cleft lip is contrasted with premaxillary agenesis, a wider defect caused by absence of the frontonasal process. The discussion on the differential diagnosis of cleft lip summarizes its common causes, including teratogenic agents (alcohol, maternal diabetes, phenytoin), chromosome anomalies (aneuploidy, recurrent deletion syndromes), and Mendelian clefting disorders that include associated malformations in other organ systems. The chapter gives recommendations for evaluation and management. A clinical case presentation features an infant with an oral cleft who has a positive family history of cleft lip and palate with paramedian lip pits due to Van der Woude syndrome.


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