PHARYNGEAL ARCHES GENETICS FACTORS CONTRIBUTING TO CLEFT LIP AND PALATE DAVIS AND RITCHIE CLASSIFICATION VEAU’S CLASSIFICATION(1931 KERNAHAN AND STARK(1958) VILAR- SANCHO INTERNATIONAL CLASSIFICATION (1969) BERLIN CLASSIFICATION(1979) ROSSEL PERRY CLASSIFICATION(2009

1. CLEFT LIP AND PALATE
Dr SHILPA DINESHAN

2. PHARYNGEAL ARCHES
The Developing Human:
Clinically Oriented
Embryology (8th Edition) by
Keith L. Moore and T.V.N
Persaud - Moore & Persaud
Chapter Chapter 10 The
Pharyngeal Apparatus
pp201 - 240.

4. •Larsen’s Human Embryology by GC. Schoenwolf, SB. Bleyl, PR. Brauer and PH. Francis-West - Chapter 12 Development of
the Head, the Neck, the Eyes, and the Ears pp349 - 418.

7. GENETICS FACTORS CONTRIBUTING TO CLEFT LIP
AND PALATE

8. • Gad1
• TGFA
• TGFβ3
• MSX1
• GSK-3β
• Ephrin
• Spry2

9. ENVIRONMENTAL FACTORS CONTRIBUTING TO
CLEFT LIP AND PALATE

11. DAVIS AND RITCHIE CLASSIFICATION (1922):
Davis JS, Ritchie HP. Classifi cation of congenital clefts of the lip and palate. JAMA 1922;79:1323-7.

12. VEAU’S CLASSIFICATION(1931)
Veau V. Division
Palantine. Paris:
Masson et Cie;
1931.

13. KERNAHAN AND STARK(1958)
Kernahan DA, Stark RB. A
new classifi cation for cleft lip
and cleft
palate. Plast Reconstr Surg
Transplant Bull 1958;22:435-
41.

15. HARKINS CLASSIFICATION (1962)
• Harkins CS, Berlin A, Harding RL, Longacre JJ, Snodgrasse RM. A classification of cleft lip and cleft palate. Plast Reconstr Surg
Transplant Bull. 1962;29:31–39

16. VILAR- SANCHO CLASSIFICATION
(1962)
• K-lip
• G-gnato
• U-hard palate
• S-soft palate
• 2-bilateral
• d- right
• l- left
• I- incomplete
• O- operated
• +-not affected
• Vilar-Sancho B. A proposed new international classification of congenital cleft lip and cleft palate. Plast Reconstr Surg
Transplant Bull 1962;30:263-6.

17. SCHUCHARDT & PFEIFER’S SYMBOLIC
CLASSI FICATION(1964)
Pfeifer G. Dokumentation. In Schuchardt, K. : Treatment of patients with clefts of lip, alveolus and palate. 2nd
international Symposion, Hamburg 1964. Stuttgart: Thieme 1964

18. INTERNATIONAL CLASSIFICATION (1969)
Broadbent TR, Fogh-Andersen P, Berlin AJ, Karfik V, Matthews DN, Pfeifer Newsletter of the International Confederation for
Plastic and Reconstructive Surgery Amsterdam,1969

19. OBLIQUE CLEFT
TRANSVERSE CLEFT
CLEFT OF NOSE

20. ARTURO SANTIAGO CLASSIFICATION(1969)
Santiago A. Classification of cleft lip and palate for machine record coding. The Cleft Palate Journal Archive 1969;
6(9): 434-9.

21. CLP
CP
UCP
BCLP
Dahl E. Craniofacial morphology in
congenital clefts of the lip and
palate. An x-ray cephalometric study of
young adult males. Acta
Odontol Scand 1970;28 Suppl 57:11+.
DAHL CLASSIFICATION(1970)

22. SPINA CLASSIFICATION
(1973)
GROUP I
UNILATERAL BILATERAL MEDIAL
GROUP II
UNLATERAL BILATERAL
GROUP
III
TOTAL PARTIAL
GROUP
IV
Spina V. A proposed modifi cation for the classifi cation of cleft lip and cleft palate. Cleft Palate J 1973;10:251-2.

23. BERLIN CLASSIFICATION(1979)

24. Kernahan DA. The striped Y — A symbolic classification for cleft lip and palate. Plast Reconstr Surg 1971;47:469-70.

26. MILLARDS MODIFICATION(1976)
Millard RD Jr. The naming and classifying of clefts. In: Cleft Craft. Vol. I. Boston: Little, Brown, and Co.;
1976:41–55.

27. LAHSHAL CLASSIFICATION (1987)
• Right lip
• Right alveolus
• Hard palate
• Soft palate (LAHSAL)
• Left alveolus
• Left lip
Kriens O. Lahshal: A concise documentation system for cleft lip, alvolus and palate diagnoses. In: Kriens O, editor.
What is Cleft Lip and Palate? A Multidisciplinary Update Workshop, Bremen 1987.

28. Right incomplete cleft lip and alveolus
HOW DO WE REPRESENT THIS TYPE OF CLEFT ACCORDING
TO LAHSAL CLASSIFICATION????

29. ROSSEL PERRY CLASSIFICATION(2009)
Rossell-Perry P. New diagram for cleft lip and palate description: The clock diagram. Cleft Palate Craniofac J
2009;46:305-13.
LIMA CLOCK

30. REFERENCES
• Alexandre R Vieira Association between the transforming growth alpha
gene and nonsyndromic oral clefts: a HuGE review. Am. J. Epidemiol.:
2006, 163(9);790-810
• Min Shi, George L Wehby, Jeffrey C Murray Review on genetic variants
and maternal smoking in the etiology of oral clefts and other birth
defects. Birth Defects Res. C Embryo Today: 2008, 84(1);16-29
• Michael J Dixon, Mary L Marazita, Terri H Beaty, Jeffrey C Murray Cleft
lip and palate: understanding genetic and environmental influences. Nat.
Rev. Genet.: 2011, 12(3);167-78
• Won-Jong Oh, Joby J Westmoreland, Ryan Summers, Brian G
Condie Cleft palate is caused by CNS dysfunction in Gad1 and Viaat
knockout mice.PLoS ONE: 2010, 5(3);e9758

31. • The Developing Human: Clinically Oriented Embryology (8th
Edition) by Keith L. Moore and T.V.N Persaud - Moore & Persaud
Chapter Chapter 10 The Pharyngeal Apparatus pp201 - 240.
•Larsen’s Human Embryology by GC. Schoenwolf, SB. Bleyl, PR.
Brauer and PH. Francis-West - Chapter 12 Development of the Head, the
Neck, the Eyes, and the Ears pp349 - 418.
•Davis JS, Ritchie HP. Classifi cation of congenital clefts of the lip and
palate. JAMA 1922;79:1323-7.
•Rossell-Perry P. New diagram for cleft lip and palate description: The
clock diagram. Cleft Palate Craniofac J 2009;46:305-13.
•Kriens O. Lahshal: A concise documentation system for cleft lip,
alvolus and palate diagnoses. In: Kriens O, editor. What is Cleft Lip and
Palate? A Multidisciplinary Update Workshop, Bremen 1987.

32. • Kernahan DA. The striped Y — A symbolic classification for cleft lip
and palate. Plast Reconstr Surg 1971;47:469-70
• Spina V. A proposed modifi cation for the classifi cation of cleft lip
and cleft palate. Cleft Palate J 1973;10:251-2.
• Vilar-Sancho B. A proposed new international classification of
congenital cleft lip and cleft palate. Plast Reconstr Surg Transplant
Bull 1962;30:263-6
• Veau V. Division Palantine. Paris: Masson et Cie; 1931.
• Harkins CS, Berlin A, Harding RL, Longacre JJ, Snodgrasse RM. A
classification of cleft lip and cleft palate. Plast Reconstr Surg
Transplant Bull. 1962;29:31–39