Let’s Face It: Causes, treatment and consequences of rare facial clefts Versnel, S.L. 2010-11-12 Doctoral Thesis Plastic and Reconstructive Surgery

The incidence of a congenital malformation is 1 on 33 live newborn. A congenital malformation can occur in all tissues and all body parts, and can present as an isolated malformation or as a part of a syndrome. Congenital malformations of the skull, face and jaws represent the craniofacial malformations. There are numerous types of congenital craniofacial malformations, which differ in location, pathomorphogenesis and incidence among other things. Congenital craniofacial clefts, other than just clefts of the lip and palate, are a very rare condition. These ‘rare facial clefts’ encompass a wide variety of craniofacial dysmorphologies. All facial parts and all tissue-layers of the face can be involved in various degrees of severity. Bone and soft tissues are rarely involved to the same extent. The cleft can occur unilaterally or bilaterally, in the midline of the face or more paramedian or oblique. The affected soft tissue and/or skeletal elements show a disturbed growth-pattern, resulting in more obvious or more severe deformities over the years. This underdevelopment of soft tissue and osseous structures occurs in three dimensions.
http://repub.eur.nl/res/pub/22637/101112_Versnel%2C%20Sarah%20Lisa_Full.pdf