Van der Woude Syndrome

Inherited developmental disorder characterized by pits of the lower lip and cleft lip or cleft palate. It is the most common cleft lip/palate syndrome.

Cleft Lip and/or Palate with Mucous Cysts of Lower Lip; Lip-Pit Syndrome; Lip-Pit-Cleft Syndrome.

Congenital genetic disorder first studied by A. Van der Woude in 1954.

1:70,000 live births.

Autosomal dominant.

Caused by mutations in the gene encoding interferon regulatory factor-6 located on 1q32-q41; allelic to popliteal pterygium syndrome. Clinical expression is highly variable from one individual to another.

Clinically evocated in patients with cleft lip or palate and mucous cysts of lower lip. Lip-Pit Syndrome is the most common manifestation present in 90% of the affected. The cleft of lip and palate occur in 21%.

Generally concerns only head with lower lip pits (corresponding to accessory salivary glands), cleft lip, cleft palate, cleft uvula, and hypodontia.

Evaluate the airway (clinical, radiographs) and teeth mobility.

Direct laryngoscopy and tracheal intubation can be difficult because of cleft syndrome. Teeth lesions can occur more frequently.

Avoid muscle relaxants until confirmation that face-mask ventilation is possible or airway is secured.