The spectrum of orofacial clefting.
OBJECTIVE
After studying this article, the participant should be able to: 1. Describe the differing types of congenital clefting defects that extend outward from the perioral region. 2. Define the sites of anatomical disruption and deformities that these types of facial clefts cause. 3. Describe the cause and incidence, if known, of orofacial clefts and their inheritance/transmission risks.


BACKGROUND
Clefts of the orofacial region are among the most common congenital facial defects. The clinical presentation is usually that of a lateral cleft of the lip through the philtrum with or without extension through the palatal shelves. However, atypical forms of clefts with lip involvement also occur in a variety of patterns, some of which are embryologically predictable; others are not.


METHODS
An overview of the embryology, cause, and incidence of this diverse and interesting group of congenital orofacial clefts is presented.


RESULTS
Clefts involving the lateral upper lip; median upper lip; and oblique facial, lateral facial, and median mandibular regions are reviewed.


CONCLUSIONS
This review of orofacial malformations describes clefting anomalies that emanate from the mouth and lips. As the causes of orofacial clefts are better understood, it is becoming clear that a complex interplay between genetic and environmental variables causes these clefts. Future study of orofacial clefts will require increasingly sophisticated methods of elucidating these subtle interactions.
Eppley
Barry L
BL
Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. beppley@iupui.edu
van Aalst
John A
JA
Robey
Ashley
A
Havlik
Robert J
RJ
Sadove
A Michael
AM
D000015:Abnormalities, Multiple; D000428:Alcohol Drinking; D002971:Cleft Lip / Q000145:classification / Q000196:embryology / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D002972:Cleft Palate / Q000145:classification / Q000196:embryology / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D005260:Female; D005494:Folic Acid Deficiency / Q000150:complications; D016142:Holoprosencephaly / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012907:Smoking; D012959:Socioeconomic Factors; D013577:Syndrome