Cleft and Craniofacial Plastic and Reconstructive Surgery

  • Ghassan S. Abu-SittahEmail author
  • Rawad S. Chalhoub
Living reference work entry


Oral clefts represent one of the most common birth defects in the world, with global incidence of about 1:700 and multifactorial etiology. No reliable epidemiological data is present on oral clefts in the Middle East but variable obstacles to proper care are well documented and studied. With the epidemic of conflict in the region, new obstacles and an increase in risk factors associated with oral clefts are challenging care providers. New models must be put in place to spread the awareness and care needed for cleft care to prevent long-term disability in children with oral clefts. This chapter sheds light on some of the challenges facing cleft and craniofacial care in the Middle East.


Cleft lip Cleft palate Arab world Middle East Oral clefts Craniofacial deformities 


  1. Aldhorae KA, Böhmer AC, Ludwig KU, Esmail AHA, Al-Hebshi NN, Lippke B, Gölz L, Nöthen MM, Daratsianos N, Knapp M (2014) Nonsyndromic cleft lip with or without cleft palate in Arab populations: genetic analysis of 15 risk loci in a novel case–control sample recruited in Yemen. Birth Defects Res A Clin Mol Teratol 100:307–313CrossRefGoogle Scholar
  2. Aljohar A, Ravichandran K, Subhani S (2008) Pattern of cleft lip and palate in hospital-based population in Saudi Arabia: retrospective study. Cleft Palate Craniofac J 45:592–596CrossRefGoogle Scholar
  3. Alkire B, Hughes CD, Nash K, Vincent JR, Meara JG (2011) Potential economic benefit of cleft lip and palate repair in sub-Saharan Africa. World J Surg 35:1194–1201CrossRefGoogle Scholar
  4. Batniji R, Khatib L, Cammett M, Sweet J, Basu S, Jamal A, Wise P, Giacaman R (2014) Governance and health in the Arab world. Lancet 383:343–355CrossRefGoogle Scholar
  5. Brooklyin S, Jana R, Aravinthan S, Adhisivam B, Chand P (2014) Assessment of folic acid and DNA damage in cleft lip and cleft palate. Clin Pract 4:608CrossRefGoogle Scholar
  6. Derijcke A, Eerens A, Carels C (1996) The incidence of oral clefts: a review. Br J Oral Maxillofac Surg 34:488–494CrossRefGoogle Scholar
  7. Elahi MM, Jackson IT, Elahi O, Khan AH, Mubarak F, Tariq GB, Mitra A (2004) Epidemiology of cleft lip and cleft palate in Pakistan. Plast Reconstr Surg 113:1548–1555CrossRefGoogle Scholar
  8. Esmail AH, Abdo MA, Krentz H, Lenz JH, Gundlach KK (2014) Centre-based statistics of cleft lip with/without alveolus and palate as well as cleft palate only patients in Aden, Yemen. J Craniomaxillofac Surg 42:297–304CrossRefGoogle Scholar
  9. Fouad FM, Sparrow A, Tarakji A, Alameddine M, El-Jardali F, Coutts AP, El Arnaout N, Karroum LB, Jawad M, Roborgh S (2017) Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet–American University of Beirut Commission on Syria. Lancet 390:P2516–2526CrossRefGoogle Scholar
  10. Hughes CD, Babigian A, McCormack S, Alkire BC, Wong A, Pap SA, Vincent JR, Meara JG, Castiglione C, Silverman R (2012) The clinical and economic impact of a sustained program in global plastic surgery: valuing cleft care in resource-poor settings. Plast Reconstr Surg 130:87e–94eCrossRefGoogle Scholar
  11. Katzel EB, Basile P, Koltz PF, Marcus JR, Girotto JA (2009) Current surgical practices in cleft care: cleft palate repair techniques and postoperative care. Plast Reconstr Surg 124:899–906CrossRefGoogle Scholar
  12. Magee WP Jr, Vander Burg R, Hatcher KW (2010) Cleft lip and palate as a cost-effective health care treatment in the developing world. World J Surg 34:420–427CrossRefGoogle Scholar
  13. Massenburg BB, Jenny HE, Saluja S, Meara JG, Shrime MG, Alonso N (2016) Barriers to cleft lip and palate repair around the world. J Craniofac Surg 27:1741–1745CrossRefGoogle Scholar
  14. Murray JC (2002) Gene/environment causes of cleft lip and/or palate. Clin Genet 61:248–256CrossRefGoogle Scholar
  15. Sabbagh HJ, Innes NP, Sallout BI, Alamoudi NM, Hamdan MA, Alhamlan N, Al-Khozami AI, Abdulhameed FD, Al-Aama JY, Mossey PA (2015) Birth prevalence of non-syndromic orofacial clefts in Saudi Arabia and the effects of parental consanguinity. Saudi Med J 36:1076–1083CrossRefGoogle Scholar
  16. Schwarz R, Bhai Khadka S (2004) Reasons for late presentation of cleft deformity in Nepal. Cleft Palate Craniofac J 41:199–201CrossRefGoogle Scholar
  17. Standards for cleft palate and craniofacial teams (2019) Accessed 31 Mar
  18. Tadmouri GO, Nair P, Obeid T, Al Ali MT, Al Khaja N, Hamamy HA (2009) Consanguinity and reproductive health among Arabs. Reprod Health 6:17CrossRefGoogle Scholar
  19. Thong MK, Ho JJ, Khatijah NN (2005) A population-based study of birth defects in Malaysia. Ann Hum Biol 32:180–187CrossRefGoogle Scholar
  20. van Aalst JA (2015) Cleft and craniofacial care in Palestine: breaking from the cycle of the past. J Craniofac Surg 26:2396–2399CrossRefGoogle Scholar
  21. Zbar RI, Rai SM, Dingman DL (2000) Establishing cleft malformation surgery in developing nations: a model for the new millennium. Plast Reconstr Surg 106:886–889; discussion 90–91CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Plastic and Reconstructive SurgeryAmerican University of Beirut Medical CenterBeirutLebanon

Section editors and affiliations

  • Diana Arabiat
    • 1
    • 2
  • Huda Omer Basaleem
    • 3
  1. 1.School of Nursing and MidwiferyEdith Cowan UniversityJoondalupAustralia
  2. 2.Faculty of NursingThe University of JordanAmmanJordan
  3. 3.Department of Community Medicine and Public HealthFaculty of Medicine and Health Sciences, University of AdenAdenYemen

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