DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172521

A cross-sectional study of cardiac anomalies among children with orofacial cleft - role of echocardiography

R. Priyadharshini, Saji James, Jebaraj Rathinasamy, Mahalakshmi R., Gautham Gopalakrishnan, Jacquilyne Kharlukhi

Abstract


Background: Orofacial cleft is one of the most common congenital facial abnormalities. Congenital heart disease (CHD) has been reported in up to 15% of the patients with orofacial clefts. Clinical cardiac examinations may sometime miss cardiac anomalies in children with orofacial clefts. The aim of our study is to find out CHD by echocardiography and to correlate this with clinical examination findings in children with orofacial clefts.

Methods: In this cross-sectional study, 510 patients with orofacial clefts aged 1 month to 18 years were enrolled. History and clinical examination were performed and data entered in a pre-validated proforma. The type of orofacial cleft and syndromic features was specifically noted. Echocardiography was performed for all patients by a paediatric cardiologist and the clinical cardiovascular findings were correlated with the echocardiogram.

Results: The commonest deformity was cleft lip and palate (69%), followed by isolated cleft palate (20.4%), and isolated cleft lip (10.6%). In our study population, 87.5% were non-syndromic and 12.5% were syndromic; 21.9% had cardiac anomaly, of which in 7.8% no cardiac defect was detected during systemic cardiovascular examination but their echocardiogram showed cardiac abnormality. This was statistically significant (p<0.000). Atrial Septal Defect was the commonest anomaly in both the groups. Pierre Robin Syndrome was found to be the commonest syndrome.

Conclusions: The high prevalence of CHD among children with orofacial clefts in this study justifies the need for screening echocardiography because many times cardiac anomalies might not be detected in routine systemic examination. 


Keywords


Congenital heart disease, Echocardiography, Orofacial cleft

Full Text:

PDF

References


Mossey P, Little J. Addressing the challenges of cleft lip and palate research in India. Indian J Plast Surg. 2009;42:S9-18.

Yaqoob M, Mahmood F, Hanif G, Bugvi SM, Sheikh MA. Etiology and genetic factors in clefts of lip and/or palate reported at children’s hospital, Lahore, Pakistan. Indian J Hum Genet. 2013;19(2):136-43.

Smith WP. Cleft lip and palate: developmental abnormalities of the face, mouth and jaws. In: Bailey and Love's Short Practice of Surgery, 25th ed. London:Edward Arnold; 2008.

Sah RK, Powar R. Epidemiological profile of cleft lip and palate patients attending tertiary care hospital and medical research centre, Belgaum, Karnataka- a hospital based study. IOSR J Dent Med Sci. 2014;13(5):78-81.

Venkatesh R. Syndromes and anomalies associated with cleft. Indian J Plast Surg. 2009;42:S51-5.

Shprintzen RJ, Siegel-Sadewitz VL, Amato J, Goldberg RB. Anomalies associated with cleft lip, cleft palate, or both. Am J Med Genet. 1985;20:585-95.

Stoll C, Alembik Y, Dott B, Roth MP. Associated malformations in cases with oral clefts. Cleft Palat Craniofaci J. 2000;37(1):41-7.

Shafi T, Khan MR, Atiq M. Congenital heart disease and associated malformations in children with cleft lip and palate in Pakistan. British J Plast Sur. 2003;56:106-9.

Roelandt JRTC. The decline of our physical examination skills: is echocardiography to blame. European Heart J- Cariovas Imag. 2014;15(3):249-25.

Togoo RA, Yaseen SM, Meer Z, AlMohy A, AlQahtani J. A preliminary report on cleft deformities of the face and associated anomalies in Abha, Saudi Arabia. J Orofac Research. 2012; 2(4):177-91.

Murthy J, Bhaskar LVKS. Current concepts in genetic of non-syndromic cleft. Indian J Plast Surg 2009;42:68-81.

Ting Sun, et al. A Survey of congenital heart disease and other organic malformations associated with different types of orofacial clefts in eastern china. PLoS ONE. 2013;8(1):e54726.

Liang CD et al. A survey of Congenital heart disease in patients with oral clefts. Acta Paediatricia Taiwan. 1999;40:414-7.