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Classifying Clefts using the LAHSAL Code

In the UK, there has been a general move to adopt a simple system for classifying clefts, which is easy to use yet has sufficient accuracy for most purposes. The LAHSAL code was chosen as the preferred classification system.  It is compatible with ICD 10 and allows clefts to be coded for computer use, most importantly on the CRANE register.

LAHSAL_codeThe LAHSAL code

The LAHSAL code splits the relevant parts of the mouth into six parts:

  • Right lip
  • Right alveolus
  • Hard palate
  • Soft palate
  • Left  alveolus
  • Left lip

The South West Cleft Care registration form includes a simple chart that when completed gives us the LAHSAL code. Note the order in which it is written - is from the perspective of someone looking at the patient (i.e. the first character is for the patient's right lip, and the last character for the patient's left lip). The LAHSAL code indicates for each part whether there is a complete cleft (upper case letter, e.g. H), an incomplete cleft (lower case letter, e.g. h) or no cleft.