CRANIOFACIAL ANOMALIES IN INDIA: A TERTIARY CARE-BASED STUDY
Main Article Content
Keywords
Craniofacial anomalies, Congenital malformations, Craniosynostosis, Apert syndrome, Facial clefts, Tessier classification, Syndromic anomalies, Scaphocephaly, Multidisciplinary care, India, Paediatric surgery
Abstract
Craniofacial anomalies (CFAs) encompass a diverse group of congenital malformations affecting the skull, face, and associated structures, often resulting in functional and aesthetic impairments. In India, limited epidemiological data exists, particularly from tertiary care settings. This study aimed to evaluate the prevalence, demographic distribution, clinical characteristics, risk factors, and surgical outcomes of CFAs in a tertiary hospital in Delhi.
Materials and Methods: This study was conducted over 18 months at the Department of Burns, Plastic, and Maxillofacial Surgery, Safdarjung Hospital, New Delhi. A total of 112 patients with clinically diagnosed congenital CFAs were included. Patients with isolated cleft lip and/or cleft palate were excluded. Clinical, radiological, and surgical data were collected, and risk factors were assessed. Data analysis was performed using SPSS version 25.0.
Results: Most patients were aged 1–5 years (36.61%), and females predominated (64.3%). Non-syndromic CFAs were more common (54.5%) than syndromic cases (45.5%), with Apert syndrome being the most frequent syndromic diagnosis (52.9%). Facial involvement (56.3%) was more prevalent than cranial (25.9%) or combined involvement (17.9%). Among 44 craniosynostosis cases, scaphocephaly was the most common subtype. Isolated cleft palate (50.8%) was the leading facial anomaly. Improper iron and folic acid intake (16.96%) and family history (12.5%) were the most common risk factors. Multiple surgeries were required in 70.8% of surgically treated patients.
Conclusion: This study highlights the burden of CFAs in a tertiary care setting, emphasizing the predominance of non-syndromic cases and facial anomalies. Early diagnosis, nutritional interventions, genetic counselling, and multidisciplinary care are essential to improve outcomes and reduce long-term morbidity.
References
2. World Health Organization. Global registry and database on craniofacial anomalies: Report of a WHO Registry Meeting on Craniofacial Anomalies. Bauru, Brazil: WHO; 2001.
3. Fida NM, Al-Aama J, Nichols W, Alqahtani M. A prospective study of congenital malformations among live born neonates at a university hospital in Western Saudi Arabia. Saudi Med J. 2007;28(9):1367–73.
4. Sallout BI, Al-Hoshan MS, Attyyaa RA, Al Suleimat AA. Antenatal diagnosis, prevalence, and outcome of major congenital anomalies in Saudi Arabia: A hospital-based study. Ann Saudi Med. 2008;28(4):272–6.
5. Al Hosani H, Salah M, Abu-Zeid H, Farag HM, Saade D. The National Congenital Anomalies Register in the United Arab Emirates. East Mediterr Health J. 2005;11(4):690–9.
6. Rajab A, Thomas C. Oral clefts in the Sultanate of Oman. Eur J Plast Surg. 2001;24(5):230–3.
7. Aqrabawi HE. Facial cleft and associated anomalies: Incidence among infants at a Jordanian medical centre. East Mediterr Health J. 2008;14(2):356–9.
8. Wilkie AO. Craniosynostosis: Genes and mechanisms. Hum Mol Genet. 1997;6(10):1647–56.
9. Mossey P. Epidemiology underpinning research in the aetiology of orofacial clefts. Orthod Craniofac Res. 2007;10(3):114–20.
10. Das D, Modaboyina S, Agrawal S, Pushker N, Meel R, Bajaj MS. Tessier craniofacial clefts presenting to a tertiary eye care center in Northern India: Ophthalmic features and a review of management. Indian J Ophthalmol. 2022 Jul;70(7):2552–8. doi: 10.4103/ijo.IJO_86_22.
11. Lessa S, Sebastiá R, Pontello J. Lateral canthal clefts of the eyelid. Ophthalmic Plast Reconstr Surg. 2019;35(5):491–4.
12. Twigg SR, Wilkie AO. New insights into craniofacial malformations. Hum Mol Genet. 2015 Oct 15;24(R1):R50–9. doi: 10.1093/hmg/ddv228. Epub 2015 Jun 17. PMID: 26085576; PMCID: PMC4571997
13. Aziza A, Kandasamy R, Shazia S. Pattern of craniofacial anomalies seen in a tertiary care hospital in Saudi Arabia. Annals of Saudi Medicine. 2011 Sep;31(5):488-93.
14. Suresh T, Patel Z. Congenital craniofacial anomalies amongst neonates at a major government hospital in Bengaluru: A cross-sectional study. J Indian Assoc Public Health Dent. 2023 Apr 1;21(2):129–33.
15. Hou S, Liang X, Jiao Y, Yan B, Liu K, Lin H, et al. Research progress of proteomics in congenital craniofacial anomalies. J Clin Pediatr Dent. 2024 Jan 1;48(6):1–1.
16. Pongchangyoo J, Hantragool S, Rojvachiranonda N, Niyomkarn W. Sleep-disordered breathing in children with craniofacial anomalies. J Craniofac Surg. 2023 Jun 7;1–5.
17. Patel RV, Patel R, Panchal DP, Dr. Kruti J. Deliwala, Shah T, Mistry DN. Study of Gross Congenital Craniofacial Anomalies in the Tertiary Care Hospital. BJKines National Journal of Basic & Applied Sciences. 2022 Dec 10;14(2):66–70.
18. Trindade IEK. Scientific Research in Latin America: Experiences of Collaborative Projects on Craniofacial Anomalies. The Cleft Palate-Craniofacial Journal. 2006 Nov;43(6):722
19. Obuekwe& Ojo, Akintububo BO, Fomete B, Omeje KU, Sambo YT, Ngeh Mangai, et al. Rare primary craniofacial clefts: pattern, challenges, and management in a Nigerian population. Journal of Stomatology. 2020 Jan 1;73(5):240–5.
20. Kim JH, Yim S, Cho IS, Lim SW, Yang IH, Ha JH, Kim S, Baek SH. Distribution, side involvement, phenotype and associated anomalies of Korean patients with craniofacial clefts from single university hospitalbased data obtained during 1998-2018. Korean J Orthod. 2020 Nov 25;50(6):383-390. doi: 10.4041/kjod.2020.50.6.383. PMID: 33144527; PMCID: PMC7642224.
21. Karunavathi GPN, Bindu H, Shobitha GL, Deepthi K. Prevalence of fetal congenital craniofacial anomalies among pregnant women in a tertiary care hospital. Indian J Appl Res. 2023 Jun 1;25–8.
22. Morris JK, Loane M, Wahlich C, Tan J, Baldacci S, Ballardini E, et al. Hospital care in the first 10 years of life of children with congenital craniofacial anomalies in six European countries: data from the EUROlinkCAT cohort linkage study. Arch Dis Child. 2024 Feb 19;109(5):402–8.
23. Rojvachiranonda N, Chaithat B, Sawasdipanich N, Dangsomboon A, Khwanngern K, Sitthikamtiub W, et al. Current situation of non-cleft craniofacial anomalies in Thailand: A multicenter study. J Craniofac Surg. 2024 Oct 18;(1):5–9.
24. Allareddy V. Orthognathic Surgeries in Patients with Congenital Craniofacial Anomalies: Profile and Hospitalization Outcomes. The Cleft Palate-Craniofacial Journal. 2015 Nov;52(6):698–705.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Aakash Chauhan
Senior resident, Dept of Burn, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
Rakesh Kain
Professor, Dept of Burn, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
Saurabh Sagar
Senior resident, Dept of Burn, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
Dipankar Singh Mankotia
Professor, Dept of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
