Phenotypic Spectrum of Orofacial Clefts in Indonesia: Insights From Two Decades of Surgical Records

Introduction Annually, over 6000 infants are born with orofacial clefts (OFC) in Indonesia. This study provides a comprehensive analysis Of OFC patterns in Indonesia over 20 years. Methods Ethical approval was obtained from the Research Ethics Committee Universitas Padjadjaran. A retrospective analysis of 45,283 cases (2001-2021) from a Smile Train-funded surgical database was conducted. Chi-square tests were performed using Stata 17.0 to analyze gender, cleft type, and laterality. Results Cleft lip and palate (CLP) was the most common cleft type, affecting 23,200 individuals (51.23%), followed by cleft lip (CL) in 16,490 (36.42%) and cleft palate (CP) in 5593 (12.35%). Among individuals with CL, 2516 (15.26%) had bilateral clefts and 13,974 (84.74%) had unilateral clefts, with a predominance of left-sided involvement (9194; 65.29%). In the CLP group, 15,499 (66.81%) cases were unilateral, and 7701 (33.19%) were bilateral, with a similar predominance of left-sided involvement (67.55%). Males accounted for 28,254 cases (62.39%). Significant sex differences were observed across cleft types ( P < .001) and CLP laterality, whereas no significant sex differences were found in CL laterality. Conclusion The findings enhance understanding of OFC distribution in Indonesia, offering insights into its morphological patterns. These results are crucial for developing a birth defect surveillance system and planning healthcare services for OFC patients.