Vijay Kumar Diwana1, Gunjan Gupta1, Rajesh Chauhan1, Kunal Mahajan2, Aditi Mahajan1, Ranjan Gupta3, Kanika Mahajan3
1Department of Plastic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
2Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
3Department of Prosthodontics, HP Government Dental College, Shimla, Himachal Pradesh, India
Background: There are no descriptive epidemiological data available from the state of Himachal Pradesh, India quantifying the problem of orofacial clefts. The present study aims at providing the baseline data from a tertiary care center in the state, on which future population studies can be conducted. Methods: We retrospectively analyzed the clinical and epidemiological data of 926 consecutive patients of oral clefts who underwent surgical repair at our institute over a 10-year period (2007–2016). Results: Out of a total of 926 patients, 507 (54.8%) were males and 419 (45.2%) were females with a male to female ratio of 1.2:1. Cleft lip with palate (CLP) was the most common type of orofacial cleft (486; 52.5%). It was more common among males (56.1% vs. 48.2%, P = 0.01) compared to cleft palate which was more common among females (21.5% vs. 32%, P < 0.002). Overall, unilateral clefts were more common than bilateral clefts (504 vs. 179, P < 0.0002), with left side being affected more commonly (324 vs. 180, P < 0.0002). Craniofacial anomalies were the most commonly reported associated defects. Only 231 (24.9%) patients were operated within the infancy period. The average age at the time of lip repair was 2.8 years, while for palatoplasty, it was 6 years. Conclusions: Orofacial clefts showed a male predominance, high unilateral:bilateral and left:right ratios, and CLP as the most common variety. Very few patients with cleft lip and palate underwent surgery at the recommended age. There is a need to strengthen the existing health-care infrastructure and knowledge to improve the scenario.
Keywords: Cleft lip, cleft palate, epidemiology, Himachal Pradesh.