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Updating the Epidemiology of Isolated Cleft Palate

Mahabir, Raman C. M.D.; Tanaka, Shoichiro A. B.S., M.P.H.; Jupiter, Daniel C. Ph.D.; Menezes, John M. M.D.

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Plastic and Reconstructive Surgery: January 2014 - Volume 133 - Issue 1 - p 68e-69e
doi: 10.1097/01.prs.0000436820.19085.06
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We thank Dr. Lowry for taking the time to read our article,1 and we appreciate his comments. Our article was first written as an Original Article. However, at the request of the Editor, it was revised as a Viewpoint article. As such, there was a significant space constraint and much of the material that was cut to fit the shorter format would have addressed the issues he mentioned. We agree that there is some confusion about the term “isolated cleft palate.” To clarify, we used the term isolated cleft palate to mean a cleft of the palate without a cleft of the lip, as is the convention in national and international database and research efforts. Isolated cleft palate can be associated with other anomalies (e.g., cardiac) and still be considered isolated cleft palate (without cleft lip). In fact, up to 40 percent of patients with cleft palate have associated anomalies, a higher rate than cleft lip and palate. Some studies try to separate syndromic from nonsyndromic; however, we made no such attempts in describing overall rates. No sources were given, as the number of references is limited in a Viewpoint article. We referenced our earlier article2 to help clarify for anyone that was interested in reviewing the original data, and Dr. Lowry correctly identified that. His concerns about the intranational and international differences in reporting data are similarly addressed in the earlier article.2 Finally, we would agree that a 5-year study may be too short to infer trends in rates. The counterpoint, though, is that data and reporting continuously improve and more recent data may be more valuable than older data. This was the original inspiration for this series of articles. As a point of correction, we reported that the U.S. rate was increasing and the international rate was stable. The data cited by Dr. Lowry would seem to support and not refute our conclusions.


The authors have no financial interest to declare in relation to the content of this communication.

Raman C. Mahabir, M.D.

Texas A&M Health Science Center

College of Medicine, and

Division of Plastic Surgery

Scott & White Healthcare

Temple, Texas

Shoichiro A. Tanaka, B.S., M.P.H.

Texas A&M Health Science Center

College of Medicine

Temple, Texas

Daniel C. Jupiter, Ph.D.

Texas A&M Health Science Center

College of Medicine, and

Department of Surgery

Scott & White Healthcare

Temple, Texas

John M. Menezes, M.D.

Division of Plastic Surgery

University of Nevada School of Medicine

Las Vegas, Nev.


1. Tanaka SA, Mahabir RC, Jupiter DC, Menezes JM. Updating the epidemiology of isolated cleft palate. Plast Reconstr Surg. 2013;131:650e–652e
2. Tanaka SA, Mahabir RC, Jupiter DC, Menezes JM. Updating the epidemiology of cleft lip with or without cleft palate. Plast Reconstr Surg. 2012;129:511e–518e


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