Nasopharyngeal Development in Patients with Cleft Lip and Palate: A Retrospective Case-Control Study (original) (raw)
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Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2014
The aim of this study is to analyze the craniofacial morphology in patients with unrepaired isolated cleft palate (UICP) at childhood, adolescence and adulthood, in order to assess the influence of nonsurgical factors on the craniofacial growth in these patients. Lateral and posteroanterior cephalograms of 106 non-syndromic UICP patients and 102 normal matched controls were obtained and analyzed. Patients and controls were divided into three subgroups: children (5-7 years), adolescents (12-14 years), and adults (>18 years). UICP patients in childhood showed a shortened cranial basal length; reduced bony nasopharyngeal height; short maxillary depth and height with a posterior positioned maxilla and an increased width of the nasal cavity, maxilla and orbit; and a shortened mandibular length and height. UICP patients in adulthood showed a normal nasopharyngeal and mandibular morphology. However, the patients in this subgroup still showed a shortened cranial basal length, and short m...
The nasopharynx in infants with cleft lip and palate
International journal of pediatric otorhinolaryngology, 2012
The purpose of this study was to use three-dimensional computed tomography data and computer imaging technology to assess the skeletal components of the naso-pharyngeal area in patients with cleft lip and palate and to quantify anatomical variations. CT scans were obtained from 29 patients of Malay origin with cleft lip and palate aged between 0 and 12 months and 12 noncleft patients in the same age group, using a GE Lightspeed Plus Scanner housed in Hospital Universiti Sains Malaysia. Measurements were obtained using the 'Persona' three-dimensional software package, developed at Australian Craniofacial Unit, Adelaide. The results of the present study show that there is an increased nasopharyngeal space in cleft lip and palate that may lead to compression of the nasopharyngeal structures, including the Eustachian tube. Alterations of the medial pterygoid plate and the hamulus may lead to an alteration in the origin and orientation of the tensor veli palatini muscle leading t...
Upper airway features of unilateral cleft lip and palate patients in different growth stages
The Angle Orthodontist, 2019
Objectives: To compare growth-related changes of skeletal and upper airway features of unilateral cleft lip and palate subjects (UCLP) with non-cleft control (NCC) subjects by using lateral cephalograms. Materials and Methods: The sample comprised 238 subjects, collected cross-sectionally, divided into 2 groups: 94 with UCLP, and 144 NCC, subdivided into 4 groups according to their growth stages by using cervical vertebral maturation stage (CVMS). The subgroups were defined as early childhood (stage 1), prepubertal (stage 2: CVMS I and II), pubertal (stage 3: CVMS III and IV), and postpubertal (stage 4: CVMS V and VI). Results: The maxilla was more retrognathic at stages 2, 3, and 4 in females with UCLP. The mandible was more retrognathic in UCLP at stage 1 in males, and stages 2 and 3 in females. ANB (angle between NA plane and NB plane) was significantly smaller in UCLP subjects at stage 4 for both sexes. A vertical growth pattern was seen in UCLP subjects except males at stages 2...
Three-dimensional craniofacial morphology in unilateral cleft lip and palate
Journal of Oral Science, 2014
Craniofacial morphology and asymmetry were compared before, during, and after puberty within and between patients with unilateral complete cleft lip and palate (UCCLP) and a non-cleft group. In the UCCLP group, the posterior cranial base and total cranial base were significantly shorter at all skeletal periods, the maxilla was significantly retruded and posteriorly rotated, and the mandible was significantly smaller and inferoposteriorly rotated. The angle between the nasal and mandibular plane and lower anterior facial height were significantly higher, and upper posterior facial height and total posterior height were significantly lower, in the UCCLP group. Except for an increase in the nasal cavity, no significant differences were detected in facial width. For all measurements, asymmetry on the horizontal plane was more significant than that on the vertical plane. Asymmetries in the UCCLP group were mostly detected during puberty. The UCCLP group had no distinctive mandibular asymmetry, as compared with the Class I group. In UCCLP patients, the cranial base, maxilla, and mandible were affected on the sagittal plane during all growth periods. However, horizontal asymmetries were mostly detected before and during puberty. Vertical asymmetries were less severe, and there was no distinctive mandibular asymmetry as compared with the Class I group.
Early Craniofacial Morphology and Growth in Children With Unoperated Isolated Cleft Palate
The Cleft Palate-Craniofacial Journal, 2002
Objective: Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods: A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results: The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion: The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group. KEY WORDS: early craniofacial morphology and growth, isolated cleft palate, roentgencephalometry, three orthogonal projections, unilateral incomplete cleft lip Previous investigations have shown that the facial morphology in infants, children, adolescents, and adults with isolated cleft palate (ICP) deviates from the norm (e.g.
Early Craniofacial Morphology and Growth in Children with Bilateral Complete Cleft Lip and Palate
The Cleft Palate-Craniofacial Journal, 2004
Objective: Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods: A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results: The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion: The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group. KEY WORDS: early craniofacial morphology and growth, isolated cleft palate, roentgencephalometry, three orthogonal projections, unilateral incomplete cleft lip Previous investigations have shown that the facial morphology in infants, children, adolescents, and adults with isolated cleft palate (ICP) deviates from the norm (e.g.
American Journal of Orthodontics and Dentofacial Orthopedics, 2015
The craniofacial morphology of subjects with cleft lip and palate differs from that of subjects without clefts. Subjects with bilateral cleft lip and palate tend to have maxillary retrognathism, a smaller mandible with an obtuse gonial angle, greater anterior upper and lower facial heights, and retroclined maxillary incisors. The purposes of this research were to compare the skeletal and upper-airway features of subjects with bilateral cleft lip and palate with the same features in control subjects without clefts and to determine the growth-related changes at different growth stages. Methods: The sample comprised 212 subjects divided into 2 groups: 68 with bilateral cleft lip and palate, and 144 controls without clefts; each group was further divided into 4 subgroups according to growth stage using the cervical vertebral maturation stage method. The subgroups were defined as early childhood (stage 1), prepubertal (stage 2), pubertal (stage 3), and postpubertal (stage 4). The cephalometric variables were evaluated with 2-way analysis of variance and the Bonferroni test. Results: Maxillary position showed no significant differences between the male groups. The maxilla was more prognathic at stage 2 and became more retrognathic at stages 3 and 4 in the females. The mandible was more retrusive in the bilateral cleft lip and palate subjects at stage 1 in males and at stages 3 and 4 in females. ANB was larger at stages 1 and 2, and it became similar to the controls at stages 3 and 4 in male and female bilateral cleft lip and palate subjects. Vertical growth was seen in the bilateral cleft lip and palate subjects regardless of sex, and no change was observed with age. Posterior airway space was narrower in all stages (except for stage 1 in females). Middle airway space was wider after stage 1 in the male and female bilateral cleft lip and palate subjects. Inferior airway space was narrower in the male bilateral cleft lip and palate patients at the early childhood and pubertal stages. Conclusions: Age-and sex-dependent differences in skeletal morphology and upper-airway widths of the bilateral cleft lip and palate subjects were identified when compared with the control subjects without clefts.
Craniofacial Cephalometric Morphology in Caucasian Adult Patients with Cleft Palate Only (CPO)
Diagnostics
Orofacial clefts are common birth defects that affect the morphology of the skull. Cleft palate only (CPO) has a different etiology than other types of clefts, and craniofacial morphology in CPO differs from that of UCLP and BCLP. The long-term effect of the cleft and its surgery is visible after growth cessation. However, few studies exist describing cephalometric craniofacial morphology in adults with CPO. The aim of the present study was to describe the cephalometric craniofacial morphology of adult patients with CPO compared to healthy patients. The study included analysis of cephalometric lateral headfilms of 28 adults with CPO and 28 healthy subjects. It was found that the angles of SNA, ANB, 1-:NB angle (°) and Wits appraisal were significantly smaller in CPO, whereas NL-NSL (°), 1+:NA angle (°) and 1+:NA (mm) had significantly higher values in CPO compared to the control group. It has been concluded that CPO in adult patients is characterized by a sagittal jaw discrepancy du...
2021
Context: In orthodontic diagnosis, it is important to recognize the sagittal difference between the maxillary and mandibular apical bases as treatment planning aims at normalization of the maxillo-mandibular relationship. In contrast to normal individual, the development of the craniofacial complex in cleft lip/palate cases is altered and this difference may affect the growth and positioning of other facial structures. Aims: The present study is aimed at comparison of Beta angle, ANB angle, Wit’s appraisal, YEN angle and W angle for assessment of sagittal skeletal discrepancy in the patients with cleft lip / palate and to find out which is the most reliable amongst them. Methods and Material: 50 lateral cephalograms of patients with bilateral cleft lip and palate and Normal individuals were traced using Auto-cad software. After marking the points, reference lines were marked and evaluated for ANB angle, Wits Appraisal, Beta angle, YEN angle and W angle. These angles were compared fo...