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Orofacial cleft 15(OFC15)

MedGen UID:
909661
Concept ID:
C4225209
Congenital Abnormality
Synonym: OFC15
 
Gene (location): DLX4 (17q21.33)
 
Monarch Initiative: MONDO:0014772
OMIM®: 616788

Definition

Any cleft lip/palate in which the cause of the disease is a mutation in the DLX4 gene. [from MONDO]

Clinical features

From HPO
Cryptorchidism
MedGen UID:
8192
Concept ID:
C0010417
Congenital Abnormality
Cryptorchidism, or failure of testicular descent, is a common human congenital abnormality with a multifactorial etiology that likely reflects the involvement of endocrine, environmental, and hereditary factors. Cryptorchidism can result in infertility and increases risk for testicular tumors. Testicular descent from abdomen to scrotum occurs in 2 distinct phases: the transabdominal phase and the inguinoscrotal phase (summary by Gorlov et al., 2002).
Single transverse palmar crease
MedGen UID:
96108
Concept ID:
C0424731
Finding
The distal and proximal transverse palmar creases are merged into a single transverse palmar crease.
Low-set ears
MedGen UID:
65980
Concept ID:
C0239234
Congenital Abnormality
Upper insertion of the ear to the scalp below an imaginary horizontal line drawn between the inner canthi of the eye and extending posteriorly to the ear.
Protruding ear
MedGen UID:
343309
Concept ID:
C1855285
Finding
Angle formed by the plane of the ear and the mastoid bone greater than the 97th centile for age (objective); or, outer edge of the helix more than 2 cm from the mastoid at the point of maximum distance (objective).
Inguinal hernia
MedGen UID:
6817
Concept ID:
C0019294
Finding
Protrusion of the contents of the abdominal cavity through the inguinal canal.
Hyponasal speech
MedGen UID:
867782
Concept ID:
C4022173
Finding
Hyponasal speech is when there is an abnormally reduced nasal airflow during speech often in a setting of nasal obstruction or congestion.
Lagophthalmos
MedGen UID:
57517
Concept ID:
C0152226
Disease or Syndrome
A condition in which the eyelids do not close to cover the eye completely.
Bulbous nose
MedGen UID:
66013
Concept ID:
C0240543
Finding
Increased volume and globular shape of the anteroinferior aspect of the nose.
Bilateral cleft lip
MedGen UID:
451046
Concept ID:
C0392005
Congenital Abnormality
A non-midline cleft of the upper lip on the left and right sides.
Upslanted palpebral fissure
MedGen UID:
98390
Concept ID:
C0423109
Finding
The palpebral fissure inclination is more than two standard deviations above the mean for age (objective); or, the inclination of the palpebral fissure is greater than typical for age.
Ectropion of lower eyelids
MedGen UID:
636798
Concept ID:
C0521736
Disease or Syndrome
Epicanthus
MedGen UID:
151862
Concept ID:
C0678230
Congenital Abnormality
Epicanthus is a condition in which a fold of skin stretches from the upper to the lower eyelid, partially covering the inner canthus. Usher (1935) noted that epicanthus is a normal finding in the fetus of all races. Epicanthus also occurs in association with hereditary ptosis (110100).
Euryblepharon
MedGen UID:
724511
Concept ID:
C1303001
Finding
Euryblepharon is a congenital eyelid anomaly characterized by horizontal enlargement of the palpebral fissure. The eyelid is shortened vertically compared with the horizontal dimension, with associated lateral canthal malpositioning and lateral ectropion abnormally wide lid opening.
Sparse eyebrow
MedGen UID:
371332
Concept ID:
C1832446
Finding
Decreased density/number of eyebrow hairs.
Midface retrusion
MedGen UID:
339938
Concept ID:
C1853242
Anatomical Abnormality
Posterior positions and/or vertical shortening of the infraorbital and perialar regions, or increased concavity of the face and/or reduced nasolabial angle.
Palate fistula
MedGen UID:
488982
Concept ID:
C2032780
Finding
A fistula which connects the oral cavity and the pharyngeal area via the aspects of the soft palate.
High anterior hairline
MedGen UID:
477667
Concept ID:
C3276036
Finding
Distance between the hairline (trichion) and the glabella (the most prominent point on the frontal bone above the root of the nose), in the midline, more than two SD above the mean. Alternatively, an apparently increased distance between the hairline and the glabella.
Bilateral cleft palate
MedGen UID:
765998
Concept ID:
C3553084
Finding
Nonmidline cleft palate on the left and right sides.
Agenesis of lateral incisor
MedGen UID:
867502
Concept ID:
C4021881
Anatomical Abnormality
Distichiasis
MedGen UID:
98074
Concept ID:
C0423848
Anatomical Abnormality
Double rows of eyelashes.
Sparse eyelashes
MedGen UID:
375151
Concept ID:
C1843300
Finding
Decreased density/number of eyelashes.
Hypertelorism
MedGen UID:
9373
Concept ID:
C0020534
Finding
Although hypertelorism means an excessive distance between any paired organs (e.g., the nipples), the use of the word has come to be confined to ocular hypertelorism. Hypertelorism occurs as an isolated feature and is also a feature of many syndromes, e.g., Opitz G syndrome (see 300000), Greig cephalopolysyndactyly (175700), and Noonan syndrome (163950) (summary by Cohen et al., 1995).

Professional guidelines

PubMed

Bromley R, Adab N, Bluett-Duncan M, Clayton-Smith J, Christensen J, Edwards K, Greenhalgh J, Hill RA, Jackson CF, Khanom S, McGinty RN, Tudur Smith C, Pulman J, Marson AG
Cochrane Database Syst Rev 2023 Aug 29;8(8):CD010224. doi: 10.1002/14651858.CD010224.pub3. PMID: 37647086Free PMC Article
Garrocho-Rangel A, Serrano-Aguilar G, Hernández-Molinar Y, Aranda-Romo S, Alejandri-Gamboa V, Pozos-Guillén A
Spec Care Dentist 2023 Mar;43(2):152-162. Epub 2022 Jul 25 doi: 10.1111/scd.12752. PMID: 35879828
Jugessur A, Farlie PG, Kilpatrick N
Oral Dis 2009 Oct;15(7):437-53. Epub 2009 Jul 2 doi: 10.1111/j.1601-0825.2009.01577.x. PMID: 19583827

Recent clinical studies

Etiology

Ravel A, Mircher C, Rebillat AS, Cieuta-Walti C, Megarbane A
Arch Pediatr 2020 Jan;27(1):53-60. Epub 2019 Nov 26 doi: 10.1016/j.arcped.2019.11.008. PMID: 31784293
Jonsson L, Magnusson TE, Thordarson A, Jonsson T, Geller F, Feenstra B, Melbye M, Nohr EA, Vucic S, Dhamo B, Rivadeneira F, Ongkosuwito EM, Wolvius EB, Leslie EJ, Marazita ML, Howe BJ, Moreno Uribe LM, Alonso I, Santos M, Pinho T, Jonsson R, Audolfsson G, Gudmundsson L, Nawaz MS, Olafsson S, Gustafsson O, Ingason A, Unnsteinsdottir U, Bjornsdottir G, Walters GB, Zervas M, Oddsson A, Gudbjartsson DF, Steinberg S, Stefansson H, Stefansson K
J Dent Res 2018 May;97(5):515-522. Epub 2018 Jan 24 doi: 10.1177/0022034517750109. PMID: 29364747Free PMC Article
Verrotti A, Mencaroni E, Castagnino M, Zaccara G
Expert Opin Drug Saf 2015 Oct;14(10):1563-71. Epub 2015 Sep 2 doi: 10.1517/14740338.2015.1084288. PMID: 26329145
Racusin D, Stevens B, Campbell G, Aagaard KM
Semin Perinatol 2012 Jun;36(3):213-21. doi: 10.1053/j.semperi.2012.05.001. PMID: 22713503Free PMC Article
Jugessur A, Farlie PG, Kilpatrick N
Oral Dis 2009 Oct;15(7):437-53. Epub 2009 Jul 2 doi: 10.1111/j.1601-0825.2009.01577.x. PMID: 19583827

Diagnosis

Ravel A, Mircher C, Rebillat AS, Cieuta-Walti C, Megarbane A
Arch Pediatr 2020 Jan;27(1):53-60. Epub 2019 Nov 26 doi: 10.1016/j.arcped.2019.11.008. PMID: 31784293
Reddy SG, Reddy RR, Vaidhyanathan A, Markus A, Snook J
Int J Oral Maxillofac Surg 2013 Nov;42(11):1424-6. Epub 2013 May 8 doi: 10.1016/j.ijom.2013.03.021. PMID: 23664420
Racusin D, Stevens B, Campbell G, Aagaard KM
Semin Perinatol 2012 Jun;36(3):213-21. doi: 10.1053/j.semperi.2012.05.001. PMID: 22713503Free PMC Article
Rodríguez-Caballero A, Torres-Lagares D, Rodríguez-Pérez A, Serrera-Figallo MA, Hernández-Guisado JM, Machuca-Portillo G
Med Oral Patol Oral Cir Bucal 2010 May 1;15(3):e473-8. doi: 10.4317/medoral.15.e473. PMID: 20038906
Jugessur A, Farlie PG, Kilpatrick N
Oral Dis 2009 Oct;15(7):437-53. Epub 2009 Jul 2 doi: 10.1111/j.1601-0825.2009.01577.x. PMID: 19583827

Therapy

Bromley R, Adab N, Bluett-Duncan M, Clayton-Smith J, Christensen J, Edwards K, Greenhalgh J, Hill RA, Jackson CF, Khanom S, McGinty RN, Tudur Smith C, Pulman J, Marson AG
Cochrane Database Syst Rev 2023 Aug 29;8(8):CD010224. doi: 10.1002/14651858.CD010224.pub3. PMID: 37647086Free PMC Article
Verrotti A, Mencaroni E, Castagnino M, Zaccara G
Expert Opin Drug Saf 2015 Oct;14(10):1563-71. Epub 2015 Sep 2 doi: 10.1517/14740338.2015.1084288. PMID: 26329145
Ray JG, Meier C, Vermeulen MJ, Wyatt PR, Cole DE
J Pediatr 2003 Dec;143(6):805-7. doi: 10.1067/S0022-3476(03)00495-5. PMID: 14657833
Ericson A, Källén BA
Reprod Toxicol 2001 Jul-Aug;15(4):371-5. doi: 10.1016/s0890-6238(01)00137-x. PMID: 11489592
Kurppa K, Rantala K, Nurminen T, Holmberg PC, Starck J
Scand J Work Environ Health 1989 Apr;15(2):111-6. doi: 10.5271/sjweh.1874. PMID: 2772573

Prognosis

Curtis SW, Carlson JC, Beaty TH, Murray JC, Weinberg SM, Marazita ML, Cotney JL, Cutler DJ, Epstein MP, Leslie EJ
Hum Genet 2023 Oct;142(10):1531-1541. Epub 2023 Sep 7 doi: 10.1007/s00439-023-02596-4. PMID: 37676273
Hoebel AK, Drichel D, van de Vorst M, Böhmer AC, Sivalingam S, Ishorst N, Klamt J, Gölz L, Alblas M, Maaser A, Keppler K, Zink AM, Dixon MJ, Dixon J, Hemprich A, Kruse T, Graf I, Dunsche A, Schmidt G, Daratsianos N, Nowak S, Aldhorae KA, Nöthen MM, Knapp M, Thiele H, Gilissen C, Reutter H, Hoischen A, Mangold E, Ludwig KU
J Dent Res 2017 Oct;96(11):1314-1321. Epub 2017 Aug 2 doi: 10.1177/0022034517722761. PMID: 28767323
Sadoh WE, Ikhurionan P, Imarengiaye C
Cardiovasc J Afr 2016 Sep/Oct 23;27(5):276-280. Epub 2016 Sep 9 doi: 10.5830/CVJA-2016-006. PMID: 27701485Free PMC Article
Rodríguez-Caballero A, Torres-Lagares D, Rodríguez-Pérez A, Serrera-Figallo MA, Hernández-Guisado JM, Machuca-Portillo G
Med Oral Patol Oral Cir Bucal 2010 May 1;15(3):e473-8. doi: 10.4317/medoral.15.e473. PMID: 20038906
Kozelj V
J Craniomaxillofac Surg 1996 Dec;24(6):378-82. doi: 10.1016/s1010-5182(96)80040-0. PMID: 9032607

Clinical prediction guides

Hoebel AK, Drichel D, van de Vorst M, Böhmer AC, Sivalingam S, Ishorst N, Klamt J, Gölz L, Alblas M, Maaser A, Keppler K, Zink AM, Dixon MJ, Dixon J, Hemprich A, Kruse T, Graf I, Dunsche A, Schmidt G, Daratsianos N, Nowak S, Aldhorae KA, Nöthen MM, Knapp M, Thiele H, Gilissen C, Reutter H, Hoischen A, Mangold E, Ludwig KU
J Dent Res 2017 Oct;96(11):1314-1321. Epub 2017 Aug 2 doi: 10.1177/0022034517722761. PMID: 28767323
Mitsui SN, Yasue A, Masuda K, Naruto T, Minegishi Y, Oyadomari S, Noji S, Imoto I, Tanaka E
Sci Rep 2016 Dec 5;6:38398. doi: 10.1038/srep38398. PMID: 27917906Free PMC Article
Sadoh WE, Ikhurionan P, Imarengiaye C
Cardiovasc J Afr 2016 Sep/Oct 23;27(5):276-280. Epub 2016 Sep 9 doi: 10.5830/CVJA-2016-006. PMID: 27701485Free PMC Article
Brito LA, Yamamoto GL, Melo S, Malcher C, Ferreira SG, Figueiredo J, Alvizi L, Kobayashi GS, Naslavsky MS, Alonso N, Felix TM, Zatz M, Seruca R, Passos-Bueno MR
Hum Mutat 2015 Nov;36(11):1029-33. Epub 2015 Aug 3 doi: 10.1002/humu.22827. PMID: 26123647
Mertes F, Martinez-Morales JR, Nolden T, Spörle R, Wittbrodt J, Lehrach H, Himmelbauer H
Gene Expr Patterns 2009 Dec;9(8):562-7. Epub 2009 Sep 18 doi: 10.1016/j.gep.2009.09.003. PMID: 19766735

Recent systematic reviews

Bromley R, Adab N, Bluett-Duncan M, Clayton-Smith J, Christensen J, Edwards K, Greenhalgh J, Hill RA, Jackson CF, Khanom S, McGinty RN, Tudur Smith C, Pulman J, Marson AG
Cochrane Database Syst Rev 2023 Aug 29;8(8):CD010224. doi: 10.1002/14651858.CD010224.pub3. PMID: 37647086Free PMC Article
Fonseca-Souza G, de Oliveira LB, Wambier LM, Scariot R, Feltrin-Souza J
Clin Oral Investig 2022 Aug;26(8):5089-5103. Epub 2022 Jun 21 doi: 10.1007/s00784-022-04540-8. PMID: 35729285
Grewcock RE, Innes NPT, Mossey PA, Robertson MD
Oral Dis 2022 Jul;28(5):1400-1411. Epub 2022 Mar 22 doi: 10.1111/odi.14183. PMID: 35263806Free PMC Article
Sabbagh HJ, Hassan MH, Innes NP, Elkodary HM, Little J, Mossey PA
PLoS One 2015;10(3):e0116963. Epub 2015 Mar 11 doi: 10.1371/journal.pone.0116963. PMID: 25760440Free PMC Article
McIntyre GT, Mossey PA
J Orthod 2002 Mar;29(1):23-9. doi: 10.1093/ortho/29.1.23. PMID: 11907306

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