Objectives: To determine various types of cleft lip and palate, its geographical distribution and its association with cousin marriages, family history and other craniofacial syndromes in the Southern Pakistani population.

Study design: Cross-sectional study

Place and Duration of Study: Plastic Surgery Department of Sheikh Zayed Medical College / Hospital, Rahim Yar Khan and Hamza Medicare, Rahim Yar Khan from January 2020 to March 2021.

Methodology: All patients who presented to the outpatients department with cleft deformities of lip and palate, irrespective of their age and gender were included in the study. Patients who were operated previously and those who were not agree with the study protocol were excluded from the study. The data were collected through a structured proforma as well as history and physical examination. The data were organized and analyzed through Statistical Package for Social Sciences version 23.

Results: Total of 403 patients with cleft lip and palate deformities were included in this study, with an average age of 39±62 months. Out of total 239 59.3% were males with male to females ratio of 1.4:1. Cleft lip with cleft palate, cleft palate only and isolated cleft lip were found in 56.8%, 13.4% and 29.20% of cases respectively and 2 (0.5%) cases of median cleft. Out of total, 155 (38.5%) were from Southern Punjab, 50.6% from Sindh and 10.9% were from Baluchistan Province. In 386 (95.8%) cases parent had a History of cousin marriage, and family history of Cleft Lip & Cleft Palate was positive in 67 (16.6%) cases. Other congenital anomalies were found in 12.5% of cases.

Conclusion: Cleft lip and palate deformities affected the male population more than females. Cleft lip in association with cleft palate is the commonest deformity. Isolated cleft palate mainly affected females. The high incidence of these anomalies in cousin marriages emphasizes educating the people to avoid cousin marriages.

Key Words: Cleft Lip, Cleft Palate, Consanguinity, Family history. Congenital deformities