Congenital Malformations and Cleft Lip and Palate

Abstract

There is general agreement among authorities (8, 10, 14, 16) that a higher incidence of additional congenital malformations exists in the cleft palate population than in the noncleft palate population. However, reports of the incidence of associated congenital malformations in the cleft palate population vary widely. The reported incidence of congenital malformations among cleft palate groups has ranged from 3% to 33% (3, 4, 11, 12, 15, 16). These percentages are in marked contrast to the reported incidence of congenital malformations in the general population: approximately 1%. In a study of 1013 patients with cleft lip and/or cleft palate, Fogh-Andersen (2) reported associated structural malformations in more than 10%, with three or more abnormalities occurring occasionally. Loretz, Westmoreland, and Richards (9) reported that of 368 cases of cleft palate, 67 had a total of 127 malformations in addition to cleft lip and palate. Kitamura and Kraus (6) found that in thirty fetuses with clefts there were 306 anomalies in addition to the cleft. All types of cleft-associated anomalies do not occur with equal frequency. Loretz, Westmoreland, and Richards (9) found that malfor-mations of the bones and joints are the most commonly found malforma-tions in conjunction with cleft lip and/or palate. According to Ivy (5) and McKeown and Record (13), anomalies of the nervous system oc— curred most frequently, while Kraus, Kitamura, and Ooe (7) reported that brachdactyly and syndactyly were the malformations most frequently seen in cleft lip and/or palate fetuses. Other malformations frequently accompanying cleft palate are: eye abnormalities; supernumerary fingers , toes, and teeth; malformed ears; clubbed hands or feet; tongue abnormalities; microglossia and mandibular micrognathia (1). The sex difference in the occurrence of additional anomalies is unsettled ; however, on the basis of current published research it would appear that slightly more girls than boys are born with malformations in addition to cleft palate defects. According to Lutz and Moor (11) 62% of the cleft associated defects were in females, while Ivy (5) found that slightly more than 50% of the associated anomalies were observed in cleft palate males. The type of cleft palate defect and frequency with which associated 334;