Patterns of Orofacial Cleft Phenotypes and Their Associated Sequelae: A 3-Year Retrospective Study at a Tertiary Referral Hospital in West Africa

Objective To determine the demographic distribution, anatomical patterns and associated complications of orofacial clefts (OFCs) at a major tertiary referral centre in Ghana. Design A retrospective cross-sectional review of patient records. Setting The Cleft Centre of the Oral and Maxillofacial Surgery Department, a tertiary Institution in West Africa. Patients/participants Records of all patients managed for OFCs between January 2017 and December 2019. After exclusions for incomplete data, 189 patients were included. Interventions Not applicable (observational study). Main outcome measure(s) Primary outcomes were frequencies and percentages of cleft types (cleft lip with or without cleft alveolus [CL ± A], cleft lip and palate [CLP], cleft palate only [CPO]), laterality, completeness and associated complications/anomalies. Results Of 189 patients, 101 (53.4%) were male and 88 (46.6%) were female. The median age at presentation was 4 months. CL ± A was most common (38.6%, n = 73), followed by CLP (34.9%, n = 66) and CPO (26.5%, n = 50). Unilateral clefts (79.5%) and left-sided defects (60.3%) predominated. Feeding difficulties were the most frequent complication (59.1% of 93 patients with complications). Associated anomalies were present in 36 patients (19.0%). Conclusions OFCs present a significant burden at this tertiary centre. Determining patterns of cleft phenotypes informs surgical timing and type, highlighting the need for policies to allocate resources for multidisciplinary care.