Skip to content
left end
left end
right end

Information

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