Classifying clefts using the LAHSHAL 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 mostpurposes. The LAHSHAL 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.
The LAHSHAL code splits the relevant parts of the mouth into
seven parts:
- Right lip
- Right alveolus
- Hard palate
- Soft palate
- Hard palate
- Left alveolus
- Left lip
The South West Cleft Care registration form includes a simple
chart that when completed gives us the LAHSHAL code.
Phenotypic description by LAHSHAL classification [CA:
cleft alveolus; CL: cleft lip; CP: cleft palate; CL/P: cleft lip
with or without palate].
LAHSHAL *
Abbreviated notation
|
Phenotypic description
|
|
[LAHS•••] |
right
unilateral complete CL, complete alveolus and complete "unilateral"
CP |
|
[laHS•••] |
right
unilateral incomplete CL and alveolus, complete "unilateral"
CP |
|
[•••SHal] |
left
unilateral incomplete CL and alveolus, with complete "unilateral"
CP |
|
[LAHSHAL] |
bilateral
symmetric complete CL, complete CA, and complete "bilateral"
CP |
|
[l*HSH*L] |
bilateral
symmetric incomplete CL, notched CA, and complete "bilateral"
CP |
|
[••HSH••] |
complete
"midline" cleft of hard and soft palate |
|
[•••S•••] |
complete
"midline" cleft of soft palate |
*LAHSHAL is an acronym that indicates the anatomical
structures, starting from the right side of the patient toward the
left side: L (Right Lip); A (Right Alveolus); H (Right Hard
Palate); S (Soft Palate); H (Hard Palate Sn); A (SN Alveolus); L
(Sn Lip). The initial of the letter of the anatomical part involved
is written uppercase or lowercase depending on whether the cleft is
complete or partial. Minimal cleft is indicated by an asterisk (*);
if the anatomical part is normally developed it is indicated by a
dot (•); (e.g.,: laHS…: unilateral right incomplete cleft lip and
alveolus, unilateral complete cleft palate). Based on these
indication possibilities, the LAHSHAL system can describe over
12,000 combinations (of anatomy and severity) for CL/P.
Source: www.mdpi.com
