Abstract
This study aimed to identify commonly used classification systems by cleft providers around the world, including the perceived indications and limitations of each system. A cross-sectional survey. A total of 197 registrants from three international cleft/craniofacial meetings. Participants were sent a web-based questionnaire concerning cleft classification systems. Frequency of commonly used classification systems, their perceived indications and limitations. A total of 197 respondents from 166 different centers completed the questionnaire. Healthcare professionals from all disciplines responded, with the most frequent respondents being plastic surgeons (38.1%), maxillofacial surgeons (28.4%) and orthodontists (23.9%). Eighteen different classification systems were in use. The most frequently used systems were the International Statistical Classification of Diseases and Related Health Problems (ICD-10) (35.5%), LAHSHAL (34.0%), and Veau (32.5%) classification systems. Most respondents (32.5%) indicated that anatomical and morphological characteristics are essential components of a classification system. However, respondents indicated that their current classification systems lacked sufficient description of cleft extension and severity. Great variety in the use of classification systems exists among craniofacial specialists internationally. The results recommend the usage of the LAHSHAL classification of OFCs, due to its comprehensiveness, relatively high implementation rate globally, convenience of usage and complementarity with the ICD-10 system. Moreover, it can overcome deficiencies inextricably linked to ICD-10, such as incapacity to describe laterality and clefts of the alveolus. More international exposure to the merits of using the LAHSHAL classification system would be highly recommended.
Highlights
Orofacial clefts (OFCs) are the most common type of craniofacial anomaly, occurring in approximately 1:700 live births (Calzolari et al, 2007; Mossey and Modell, 2012; Mai et al, 2019; World Health Organization, 2021a)
Great variety in the use of classification systems exists among craniofacial specialists internationally
The results recommend the usage of the LAHSHAL classification of OFCs, due to its comprehensiveness, relatively high implementation rate globally, convenience of usage and complementarity with the ICD-10 system
Summary
Orofacial clefts (OFCs) are the most common type of craniofacial anomaly, occurring in approximately 1:700 live births (Calzolari et al, 2007; Mossey and Modell, 2012; Mai et al, 2019; World Health Organization, 2021a). OFCs can have a profound impact on a person’s quality of life, which can lead to problems with feeding, speech (eg velopharyngeal insufficiency), hearing (eg recurring otitis media), dentition (eg tooth decay), neurodevelopmental disorders, psychological aspects and socialization Cleft classification plays an important role in studying the epidemiology of OFCs. OFCs are etiologically heterogeneous, and untangling the interactions of environmental and genetic risk factors leading to OFCs requires accurate classification of cleft type (Dixon et al, 2011). A standardized, accurate phenotypic classification of clefts is crucial to understand the epidemiology of OFCs
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