Oral clefts: a review of the cases and our experience at a single institution

To identify the frequency of different types of oral clefts and presence of known risk factors among patients.

The retrospective review of 292 patients, presenting with oral clefts between 1992 and 2011, was conducted at the Aga Khan University Hospital, Karachi. A pre-designed questionnaire was used to collect details, including demographics, type of cleft, presence of known risk factors, surgical details, and follow-up visits. SPSS 16 was used for data analysis. Chi-square test and analysis of variance was used: whenever applicable.

Of the total, 168 (57-53%) patients had cleft lip with or without cleft palate, and 124 (42.5%) had cleft palate alone. The most common defect was left-sided complete cleft lip and palate and midline incomplete cleft palate in the two groups respectively. Consanguinity among the parents was found to be the most common risk factor (n = 50; 17.1%). Median age of repair was 4 months for cleft lip and 10 months for cleft palate in the first group. For the other group, the median age of primary repair was 13 months. First-week follow-up after surgery was 50% (n = 84) for the lip repair, and 65% (n = 81) for palate repair.

Our review revealed that most patients had cleft lip with or without cleft palate (CL/P). The most common risk factor was consanguinity among parents. Delay in seeking care, low follow-up rates after surgical repair of the anomaly and lack of involvement of speech therapist and orthodontist was observed.