RARE CRANIOFACIAL CLEFTS

I present a review of the pattern of rare craniofacial clefting in pat ients presenting to a tertiary referral craniofacial unit. Patients wi th an isolated rare cleft were uncommon; most had multiple axes of dis ruption. Midline and paramedian facial clefts, although occasionally o ccurring alone, often overlap with adjacent facial clefts and extend a long an upward cranial axis. The corresponding midline and paramedian facial clefts were never seen in isolation but were almost always seen with their axial downward cleft, Lateral nasal, oro-ocular, and later al forehead clefts showed diffuse and often poorly defined regions of disruption, resulting in a multiplicity in clefts. The small subgroup of patients with features of the amniotic band sequence had more and d ifferently distributed clefts compared with the larger nonamniotic ban d group.