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Isolated Cleft Lip and Palate May Not Be as "Isolated" as Once Thought

This facial deformity is more than a cosmetic problem.

An estimated 1 in 600 newborns worldwide are born with clefts of the lip, palate, or both. In about 70% of these babies, the anomaly is isolated and not part of a syndrome. These authors, who previously found that men with isolated cleft lips or palates (ICLP) have abnormal brain structure, now have built on that research in a study of children.

Fifty boys and 24 girls (age range, 7–17 years) with ICLP were found to be significantly smaller for height and head circumference than healthy children in a control group. After controlling for body size, magnetic resonance imaging showed that children with ICLP had significantly smaller brains than controls. Tissue distribution of gray matter and white matter was abnormal in boys with ICLP, but not in girls.

Comment: Children with ICLP have abnormal brain structure, but whether a cause-and-effect relation exists, or a common developmental insult leads to both conditions, is uncertain. Because of these findings and previously described associations between ICLP and cognitive deficits, we cannot be as reassuring to parents that their children with apparently isolated cleft lip and palate are otherwise normal in all respects.

— Robert A. Dershewitz, MD, MSc

Published in Journal Watch General Medicine August 16, 2007

Citation(s):

Nopoulos P et al. Abnormal brain structure in children with isolated clefts of the lip or palate. Arch Pediatr Adolesc Med 2007 Aug; 161:753-8.

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Cunningham ML. Is cleft lip and palate ever isolated? Phenotype is in the eye of the beholder. Arch Pediatr Adolesc Med 2007 Aug; 161:811-2.

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• Medline abstract (Free)