About Cuddapah et al. Paper Entitled “IRF6 Sequencing in Interrupted Clefting”

To the Editor

Cuddapah SR, Kominek S, Grant JH 3rd, Robin NH. IRF6 sequencing in interrupted clefting. Cleft Palate Craniofacial J. 2016;53:373–376.

We read with great interest the aforementioned paper and were surprised to notice that the data are conflicting with those reported in the paper “Clinical and Genetic Study on 356 Brazilian Patients With a Distinct Phenotype of Cleft Lip and Palate Without Alveolar Ridge Involvement” that our team (Alvarez et al.) published in the Journal of Cranio-Maxillo-Facial Surgery in December 2014.

Cuddapah et al. presented four cases with so-called interrupted cleft, three of them with cleft lip and submucous cleft palate and one with cleft lip and a soft palate cleft. The authors stated that this type of clefting had not been previously reported. However, we reported a large sample of 356 patients with different associations of cleft lip (CL) with cleft palate (CP) without alveolar ridge involvement (CL+CP), including 202 cases with the same phenotype reported by Cuddapah et al: 108 with CL and submucous CP, and 94 with CL with incomplete CP. The remaining 154 cases refer to additional combinations of CL+CP. Despite the diversity of terminology adopted in the literature, it was possible to find previous reports of this atypical phenotype of cleft also named “bridged clefts” (Knox and Braithwaite, 1963), “separate clefts of the lip and palate” (Ranta and Rintala, 1984), and “unconnected cleft” (Gregg et al., 1994), which were properly cited in our paper.

Unfortunately, the literature review conducted by Cuddapah et al. does not consider the aforementioned reports, which could have helped in their study's design and in the conclusions of their findings.