Ten years recording common oral clefts with a new descriptive system
Objective: After introducing a new descriptive recording system for congenital craniofacial abnormalities in The Netherlands, common oral clefts are highlighted. Design: Prospective observational study. Setting: Fifteen cleft palate teams, united in the Dutch Association for Cleft Palate and Craniofacial Anomalies, registered patients from 1997 to 2006. Patients: All unoperated patients with a common oral cleft were included. Main Outcome Measures: Detailed information and birth prevalence rates of cleft lip/alveolus, cleft lip/alveolus and palate, and cleft palate were provided, relating referral age, gender, family history, additional congenital abnormalities, and syndrome diagnoses to these three categories. Results: This study included 3512 patients, resulting in an overall prevalence of 16.6 per 10,000 live births. Patients showed a cleft lip/alveolus (28%), a cleft lip/alveolus and palate (39%), or a cleft palate (33%).The three categories exhibited very heterogeneous cleft types.Mean referral age was 5.8 months (median 3 weeks).Birth weight was the lowest in cleft palate patients (3238 g; p < .001 to .009). Cleft palate patients showed less positive family history concerning congenital anomalies (23%, p < .001 to .013), but more syndrome diagnoses were established in this category (24%, p < .001). Ten percent of all cleft patients showed additional abnormalities of the head and neck area, and 13% displayed congenital anomalies of other systems. Conclusions: This new recording method allows adequate description of common oral clefts.Many cleft types exist within these three categories and should be differentiated, because they originate from different time frames and/or cell biological mechanisms during embryogenesis.