SLC26A2 and multiple epiphyseal dysplasia type 4: OPD type II represents the more severe form of the disorder and is typically lethal in infancy [3, 62] Cleft palate abnormalities occur in approximately one-third of patients with diastrophic dysplasia and have been reported in association with Robin sequence in other SLC26A2 disorders, including recessive multiple epiphyseal dysplasia (rMED) [63, 64].