Associated Congenital Malformations, Syndromes, and Medical Conditions in Patients with Orofacial Clefts: A 10-Year Hospital-Based Study in Thailand

Krispijyakorn Sangharn^1,2Poonsak Pisek^1,3Araya Pisek⁴Buddhathida Wangsrimongkol¹Waranuch Pitiphat⁴Agnes BLOCH-ZUPAN^5,6,7,8Khunton Wichajarn⁹Supawich Morkmued^10*

• ¹Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand, Khon Kaen, Thailand
• ²School of Pediatric Oral Health, Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima, Thailand, Nakhon Ratchasima, Thailand
• ³Walailak University International College of Dentistry, Bangkok, Thailand
• ⁴Division of Dental Public Health, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand, Khon Kaen, Thailand
• ⁵Universite de Strasbourg Faculte de Chirurgie Dentaire, Strasbourg, France
• ⁶Les Hopitaux Universitaires de Strasbourg, Strasbourg, France
• ⁷Institut de Genetique et de Biologie Moleculaire et Cellulaire, Illkirch, France
• ⁸Université de Strasbourg, Institut d’études avancées (USIAS), Strasbourg, France, Strasbourg, France
• ⁹Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Khon Kaen, Thailand
• ¹⁰Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand

Introduction: Orofacial clefts (OFCs) require complex care, which is further complicated by associated congenital anomalies and medical conditions. However, the specific patterns of these associated conditions across different OFC subtypes are not well-characterized in the Thai population. This study aimed to determine the prevalence of OFC subtypes and to analyze the distribution of associated congenital malformations, syndromes, and medical conditions specific to each cleft type. Materials and methods: We conducted a retrospective analysis of 1,187 patients (0-3 years) treated at Tawanchai Cleft Center, Thailand, between 2011 and 2020. Cases were identified using ICD-10 codes and verified through medical records. Data were analyzed to determine OFC subtype prevalence and characterize the distribution of associated congenital malformations, syndromes, and medical conditions. Results: Cleft lip and palate (CLP) was the most common subtype (49.2%), followed by isolated cleft palate (CP, 28.1%) and isolated cleft lip (CL, 22.7%). A significant portion of patients (45.4%) presented with at least one associated condition. Respiratory system malformations were most prevalent (35.3%), followed by circulatory (12.2%) and musculoskeletal system anomalies (11.1%). The prevalence of associated malformations was highest in the CP group, which was strongly associated with Pierre Robin Sequence (8.2%). Among the 7% of syndromic cases, 22q11.2 deletion syndrome was the most frequent diagnosis (9.6% of syndromic cases). Medically, otitis media (51.7%) and anemia (17.3%) were significant comorbidities across all groups. Conclusion: Our findings demonstrate that the profile of associated anomalies differs significantly across OFC subtypes. This underscores the necessity for subtype-specific screening protocols and highlights the high burden of comorbidity in this population, directing a multidisciplinary approach for effective management.