Nahas Louei Darjazini, Alzamel Omar, Dali Mammdouh Yassin, Alsawah Rama, Hamsho Ahmad, Sulman Rafi, Alzamel Mohamad, Omar Abdullah
Department of Surgery Division of Otorhinolaryngology, Faculty of Medicine, Syrian Private University, Damascus, Syria.
Faculty of Medicine, Syrian Private University, Damascus, Syria.
Heliyon. 2021 Sep 7;7(9):e07957. doi: 10.1016/j.heliyon.2021.e07957. eCollection 2021 Sep.
This case-control study was conducted to determine the distribution of cleft lip and/or palate, its association with family history, syndromes and serous otitis media (SOM), and its relation with several risk factors.
The case group comprised of 133 children born with cleft lip and/or palate, and the control was 133 non-cleft children born full-term. Data was collected including age, gender, origin and risk factors for cleft lip and palate from patients' files, interviewing supervising doctors, and the patient. Data was then filled out into Excel and underwent statistical analysis using the Goodness of Fit Test and Chi-Square to determine the significance of the results.
Cleft lip and/or palate (CL/P) was slightly higher among males (51.9%). Combined cleft lip and palate (CLP) was the most common presentation (42.1%). Cleft lips (CL) were mostly complete cleft (51,5%) incomplete cleft comprised (41.1%), In the sample 35.4% of the cases were bilateral, 32.3% were right unilateral, 28.3% were left unilateral and 4% were median cleft. Cleft palate (CP) was mostly complete (46.6%) there were incomplete clefts (40%), and the remainder were submucosal (13.4%). Isolated CL and combined CLP were higher in males (51.6%, 62.5% respectively). Both isolated CP and Tessier anomaly were more common in females (64.7% and 58.3% respectively). consanguineous marriages accounted for 36.1% of cases. 21.8% of the sample had a first-degree relative and 24.8% had a second degree relative born with CL/P. There were only 7 cases (0.05%) of syndromic CL/P: Down's (4), Pierre Robin's (2), and Van der Woude Syndrome (1). A relationship was found between CL/P and the risk factors: taking anticonvulsants (without specifying the drug) (p = 0.025, OR = 10.73 C.I. 95%), taking retinoic acid (p-value = 0.049, OR = 4.75 C.I. 95%), not consuming folic acid (p-value = 0.00, OR = 28.23 C.I. 95%), and smoking cigarettes (p-value = 0.046, OR = 2.00 C.I. 95%). There was no relationship with maternal alcohol consumption or maternal diabetes (p-values = 0.652 and 0.210, respectively). SOM was present in 63.2% of patients with CL/P and were mostly isolated CP.
CL/P was only slightly higher among males. The most common condition was CLP. There was higher incidence of CL/P among second-degree relatives than first degree. Down's, Pierre Robin's, and Van der Woude Syndromes may be associated with CL/P. Taking anticonvulsants, taking retinoic acid, not consuming folic acid, and smoking cigarettes all have a role in the incidence of CL/P. More than half of the sample had an associated SOM.
本病例对照研究旨在确定唇裂和/或腭裂的分布情况，其与家族史、综合征及浆液性中耳炎（SOM）的关联，以及与多种危险因素的关系。
病例组由133例唇裂和/或腭裂患儿组成，对照组为133例足月出生的非腭裂患儿。通过查阅患者病历、询问主治医生及患者本人，收集包括年龄、性别、籍贯及唇腭裂危险因素等数据。然后将数据录入Excel，并使用拟合优度检验和卡方检验进行统计分析，以确定结果的显著性。
男性唇裂和/或腭裂（CL/P）发生率略高（51.9%）。唇腭裂（CLP）是最常见的表现形式（42.1%）。唇裂（CL）大多为完全性唇裂（51.5%），不完全性唇裂占（41.1%），样本中35.4%的病例为双侧唇裂，32.3%为右侧单侧唇裂，28.3%为左侧单侧唇裂，4%为正中唇裂。腭裂（CP）大多为完全性腭裂（46.6%），不完全性腭裂占（40%），其余为黏膜下腭裂（13.4%）。孤立性唇裂和唇腭裂合并症在男性中发生率较高（分别为51.6%、62.5%）。孤立性腭裂和泰西埃畸形在女性中更为常见（分别为64.7%和58.3%）。近亲结婚占病例的36.1%。样本中21.8%有一级亲属、24.8%有二级亲属患唇裂和/或腭裂。综合征性唇裂和/或腭裂仅有7例（0.05%）：唐氏综合征（4例）、皮埃尔·罗宾综合征（2例）和范德伍迪综合征（1例）。发现唇裂和/或腭裂与以下危险因素有关：服用抗惊厥药（未指明具体药物）（p = 0.025，OR = 10.73，95%置信区间）、服用维甲酸（p值 = 0.049，OR = 4.75，95%置信区间）、未摄入叶酸（p值 = 0.00，OR = 28.23，95%置信区间）以及吸烟（p值 = 0.046，OR = 2.00，95%置信区间）。与母亲饮酒或母亲患糖尿病无关联（p值分别为0.652和0.210）。63.2%的唇裂和/或腭裂患者患有浆液性中耳炎，且大多为孤立性腭裂。
男性唇裂和/或腭裂发生率仅略高。最常见的情况是唇腭裂。二级亲属中唇裂和/或腭裂的发生率高于一级亲属。唐氏综合征、皮埃尔·罗宾综合征和范德伍迪综合征可能与唇裂和/或腭裂有关。服用抗惊厥药、服用维甲酸、未摄入叶酸和吸烟均与唇裂和/或腭裂的发生有关。样本中超过一半的患者伴有浆液性中耳炎。
