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Altun BD, Dumlu A. Evaluation of maxillary sinus volumes and pathologies in children with and without cleft lip and palate using cone beam computed tomography. Orthod Craniofac Res 2024; 27 Suppl 1:27-34. [PMID: 37776070 DOI: 10.1111/ocr.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the maxillary sinus (MS) volume and pathologies, nasal septum (NS) deviation, and MS septa formation in children with and without cleft lip and palate (CLP); also to investigate the possible causes of MS pathologies. MATERIALS AND METHODS Cone Beam Computed Tomography (CBCT) images of 200 (100 CLP, 100 control) children (5-18 years old) were evaluated from the computer database of Marmara University Faculty of Dentistry. Children with a history of maxillofacial trauma, diseases that affect bone metabolism, orthognathic surgery, extrinsic pathologies of the MS, and accompanying syndromes were excluded. NS deviation, MS septa formation, volume, and pathologies evaluated using Mimics® software. In statistical evaluations; Student t test, paired sample t test, Chi-Square test, Fisher's Exact Chi-Square test, Continuity Correction, Chi-square analysis in one-eyed layout, McNemar test, and logistic regression analysis were used. RESULTS Total MS volume was smaller in the CLP group (21 232 mm3) than in control children (23 763 mm3) (P:0.026). NS deviation and MS pathology were more frequent in the CLP. In logistic regression analysis, there was no significant relation between the presence of NS deviation and pathology in MS. The presence of CLP increased the risk of MS pathology by 2.6 times. CONCLUSION We found that children with CLP have less MS volume and an increased rate of NS deviation and MS pathology compared to the control group. Further radiological and clinical studies are needed to explain the predisposing factors of MS pathology in children with CLP.
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Affiliation(s)
- Busra Dilara Altun
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Istanbul, Turkey
| | - Asim Dumlu
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Istanbul, Turkey
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Tunç H, Ünsal G. Comparison of the Paranasal Sinus Features of Paediatric Patients with and Without Cleft Palate: A CBCT Study. Cleft Palate Craniofac J 2024; 61:939-944. [PMID: 36594189 DOI: 10.1177/10556656221149148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES This study is performed to compare the paranasal sinus volumes in paediatric unilateral cleft palate (UCP) and healthy patients. METHODS Cone-beam computed tomography (CBCT) images of 80 patients (40 boys, 40 girls) with UCP and 80 healthy individuals (40 boys, 40 girls) were evaluated. Paranasal sinus volumes were segmented and measured using ITK-SNAP software. Descriptive statistics, Kolmogorov-Smirnov, paired sample t-test and student t-test were performed for statistical analysis. RESULTS The volumes of ethmoid, frontal and sphenoid sinus on the cleft side were not significantly different than the non-cleft side (p>0.05) in UCP patients. Maxillary sinus volume of the cleft side in UCP patients was significantly lower than the non-cleft side (p<0.05). Mean maxillary sinus volume in UCP patients was 11825.23±509.95 mm3 at the cleft side and 13497.85±358.07 mm3 at the non-cleft side. While the mean volumes of ethmoid and sphenoid sinuses of patients with UCP were not significantly different from healthy individuals (p>0.05), the mean volumes of maxillary and frontal sinuses were significantly lower than healthy individuals (p<0.05). The mean maxillary sinus volume in UCP patients was 25323±597.8 mm3 and 26666±874.3 mm3 in the control group. The mean frontal sinus volume in UCP patients was 5633±323.1 mm3 and 5735±315.2 mm3 in the control group. CONCLUSIONS UCP caused a significant reduction in maxillary and frontal sinus volumes. The results of the current study show that paranasal sinus volumes in patients with UCP should be examined in more detail to make more risk-free and effective treatment plans.
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Affiliation(s)
- Hamit Tunç
- Faculty of Dentistry, Department of Paediatric Dentistry, Burdur Mehmet Akif Ersoy University, Burdur, TURKEY
| | - Gürkan Ünsal
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Near East University, Nicosia, CYPRUS
- DESAM Institute, Artificial Intelligence in Medicine Research Group, Near East University, Nicosia, CYPRUS
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Yassaei S, Ezodini F, Shiri A, Nasr N. Maxillary Sinus Volume in Patients With Unilateral Cleft Lip and Palate by CBCT. J Craniofac Surg 2023; 34:e641-e644. [PMID: 37394696 DOI: 10.1097/scs.0000000000009457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 07/04/2023] Open
Abstract
Cleft lip and palate (CLP) is one of the most common congenital craniofacial anomalies, which can change the morphology of the skull, face, and maxillary sinus due to the disruption in the fusion of palatal shelves. This study aimed to investigate the volume and dimensions of the maxillary sinus in unilateral CLP patients along with comparing the healthy and affected sides. This cross-sectional study was conducted on 27 cone-beam computed tomography stereotypes (14 male and 13 female) of patients with unilateral CLP. Maxillary sinuses were traced separately on each side and analyzed by OnDemand3D software in a separate room with low light. The height and base area of the maxillary sinuses were measured on each side. After dividing each sinus into smaller pyramids, the volume of the sinus was obtained using the partial frustum model method and analyzed by paired t test. There was no significant difference between cleft and noncleft sides in terms of mean volume and height of the sinus ( P > 0.05). The average area of the sinus base on the cleft side was 32.77 mm 2 more than the noncleft side, and this difference was statistically significant ( P = 0.027). The mean upper maxillary sinus volume on the cleft side was 541.62 mm 3 larger than the noncleft side, but this difference was not statistically significant ( P = 0.075). Considering the age groups, the average upper sinus volume on the cleft side in patients under 20 years old was 4.66 mm 3 less than the noncleft side. In the age group of more than 20 years, the average volume of the upper sinus on the cleft side was 978.66 mm 3 more than the noncleft side. The mean volume of the lower sinus on the cleft side was 505.92 mm 3 lower than the noncleft side, and this difference was statistically significant ( P = 0.010). The average area of the sinus base of the cleft side was significantly higher than the noncleft side. Also, the lower sinus volume of the cleft side was significantly lower than the noncleft side. However, no significant difference was observed in upper sinus volume between the cleft and noncleft sides.
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Affiliation(s)
- Soghra Yassaei
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences
| | - Fatemeh Ezodini
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd
| | - Armin Shiri
- Department of Orthodontics, Isfahan (Khorasgan) Branch, Islamic Azad University of Medical Sciences, Isfahan
| | - Nazanin Nasr
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Arboleda V, Elsouri KN, Heiser SE, Bernal I, Kesselman MM, Demory Beckler M. Oral Microbiome as a Tool of Systemic Disease on Cleft Patients: A New Landscape. Cureus 2023; 15:e35444. [PMID: 36994247 PMCID: PMC10041940 DOI: 10.7759/cureus.35444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
The oral cavity microbiome comprises benign and pathogenic bacteria, with more than 700 species identified. However, the current literature regarding resident bacterial flora in the oropharyngeal cavities in cleft lip/palate (CLP) patients still needs to be completed. This review aims to evaluate the role of the oral microbiome of cleft patients as an indicator in systemic diseases for which cleft patients might be at higher risk in the short or long term. A literature review was performed in July 2020 using Biomedical Reference Collection Comprehensive, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Dentistry & Oral Sciences Source via Elton B. Stephens Company/Online Database (EBSCO), Turning Research into Practice (TRIP), and PubMed. The keywords used were "oral, bacteria, microbiome, biota, flora, cleft, palate." The resulting 466 articles were deduplicated using Endnote. The total amount of articles' abstracts without duplicates was filtered using a set criterion. The title and abstract filter criteria included 1) cleft lip (CL) and/or cleft palate (CP) patients, 2) changes in the oral microbiome in CL and/or CP patients, 3) male and female patients 0-21 years old, and 4) English language. The full-text filter criteria included 1) CL and/or CP patients vs. non-cleft control patients, 2) oral bacteria, 3) nonprocedural measurements of microorganisms, and 4) case-control studies. A Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flow chart was created using the EndNote data results. The final five articles of the systematic search indicated that the oral cavity of cleft lip and/or palate patients resulted in 1) contradicting levels of Streptococcus mitis and Streptococcus salivarius; 2) lower levels of Streptococcus gordonii, Bordetella dentium, Fusobacterium nucleatum, Veillonella parvula, Bacillus and Lautropia when compared to the control group; 3) higher levels of Staphylococcus epidermidis and Methicillin-sensitive Staphylococcus aureus compared to the control group; 4) presence of Enterobacter cloacae 36.6%, Klebsiella pneumoni 53.3%, and Klebsiella oxytoca 76.6% vs. absence in the control non-cleft group. Patients with CL and/or CP are at higher risk for caries, periodontal diseases, and upper and lower respiratory infections. The results from this review indicate that relative levels of certain bacteria may be associated with these issues. The lower levels of S. mitis, S. salivarius, S. gordini, and F. nucleatum in the oral cavity of cleft patients could be linked as a possible cause of the higher incidence of tooth decay, gingivitis and periodontal disease as high levels of these bacteria are associated with oral disease. Further, the higher incidence of sinusitis in cleft patients might be linked to low levels of S. salivarius in the oral profile of these patients. Likewise, E. cloacae, K. oxycota, and K. pneumoni have been linked with pneumonia and bronchiolitis, both of which are increased in cleft patients. The oral bacterial dysbiosis of cleft patients observed in this review may play a vital function in the oral microbiome's diversity, which could play a role in disease progression and disease markers. The pattern seen in cleft patients potentially demonstrates how structural abnormalities can lead to the onset of severe infection.
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Affiliation(s)
- Vania Arboleda
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Kawther N Elsouri
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Samantha E Heiser
- Osteopathic Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Isabel Bernal
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Marc M Kesselman
- Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Michelle Demory Beckler
- Microbiology and Immunology, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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Göksel S, Özcan İ. A CBCT Study for Anatomic Variations of Osteomeatal complex in Patients With Cleft Lip and Palate. Cleft Palate Craniofac J 2023; 60:13-20. [PMID: 34787479 DOI: 10.1177/10556656211053773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate the anatomy and variations of osteomeatal complex (OMC) by comparing patients with nonsyndromic cleft lip and palate (CLP) and control group. DESIGN This case-control study was retrospectively analyzed using cone-beam computed tomography data. SETTING Istanbul University Faculty of Dentistry Department of Dentomaxillofacial Radiology. PATIENTS The study was conducted with 100 patients (44 females, 56 males) with CLP and 100 patients in the control group, which matched gender and age (with a maximum difference of 3 years). VARIABLES OMC variations are grouped as follows: ethmoidal, conchal, uncinate process, and septal variations. Then, we evaluated the presence of these OMC variations and compared them between the two groups. STATISTICAL ANALYSIS The McNemar's test was used to determine any significant differences between the groups for all indices at the 95% confidence level. RESULTS The most common anatomic variation in this study was Agger nasi cell (97%) and concha bullosa (97%) in the patients with CLP, while Agger nasi cell was the most common variation (99%) in the controls. Moreover, the atelectatic uncinate process was the least observed variation in both groups (1%). The incidences of paradoxical concha (58%;42%), bifid concha (29%;11%), deviated nasal septum (92%;80%) were significantly higher in the CLP group (p < 0.05). CONCLUSIONS The statistically significant results found when comparing OMC anatomy between the two groups reveal the importance of three-dimensional evaluation before functional endoscopic sinus surgery in patients with CLP.
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Affiliation(s)
- Sevde Göksel
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, 566936Ankara Medipol University, Ankara, Turkey
| | - İlknur Özcan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, 37516Istanbul University, Istanbul, Turkey
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Lee S, Fernandez J, Mirjalili SA, Kirkpatrick J. Pediatric Paranasal Sinuses- Development, Growth, Pathology & Functional Endoscopic Sinus Surgery. Clin Anat 2022; 35:745-761. [PMID: 35437820 PMCID: PMC9544638 DOI: 10.1002/ca.23888] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 11/27/2022]
Abstract
The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated utilizing a number of different methods ranging from cadaveric analysis to modern cross sectional imaging with 3D modeling. An understanding of normal pediatric paranasal sinus embryology and development enables us to better determine when pathology may be affecting the normal developmental process. Cystic fibrosis, chronic sinusitis, deviated nasal septum and cleft lip and palate are some of the conditions which have been shown to effect paranasal sinus development to varying degrees. Functional endoscopic sinus surgery (FESS) is becoming increasingly common and an understanding of sinus anatomy together with when periods of rapid growth occur during childhood is important clinically. Although concerns have been raised regarding the impact of FESS on facial growth, there is limited evidence of this in regards to either changes in anthropomorphic measurements or clinical assessments of symmetry post operatively.
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Affiliation(s)
- Sophie Lee
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | - S Ali Mirjalili
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Joshua Kirkpatrick
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Srivastav S, Tewari N, Duggal R, Goel S, Rahul M, Mathur VP, Yadav R, Upadhyaya AD. Cone-Beam Computed Tomographic Assessment of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis. Cleft Palate Craniofac J 2022; 60:742-751. [PMID: 35179403 DOI: 10.1177/10556656221080359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to evaluate the maxillary sinus characteristics of patients with cleft lip and palate (CLP). The study included manuscripts which met the following criteria: (1) study of individuals with CLP in any age group or gender and (2) study of individuals in whom assessment of maxillary sinus characteristics had been done by cone-beam computed tomography. Studies with (1) individuals having special health-care needs and (2) individuals with any syndrome affecting the development of the head and neck were excluded. In total, 11 articles were included in the review, based on the inclusion and exclusion criteria. Pooled maxillary sinus volume (MSV) on the cleft sides of patients with unilateral cleft lip and palate (UCLP) was found to be 9433.14 mm3 (95% CI, 7453.99-11 412.30), which was significantly smaller than that of controls. The meta-analyses also revealed significantly reduced MSV on the cleft sides of patients with UCLP. The differences between cleft and noncleft sides of the patients with UCLP were not found to be statistically significant. Strength-of-evidence was found to be moderate in 4 characteristics, along with 10 out of 11 articles showing low risk-of-bias. It was concluded that MSV was reduced and mucosal thickening was increased/present in patients with CLP as compared with controls. The differences between MSV of cleft and noncleft sides of the patients with UCLP could not be established. However, heterogeneity was found in terms of sample size, stratification of samples by age, and evaluation of some confounding factors.
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Affiliation(s)
- Sukeshana Srivastav
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Shubhi Goel
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Morankar Rahul
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Yadav
- Centre for Dental Education and Research, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Dutt Upadhyaya
- Department of Biostatistics, 28730All India Institute of Medical Sciences, New Delhi, India
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Paknahad M, Pourzal A, Mahjoori-Ghasrodashti M, Khojastepour L. Evaluation of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate Using Cone Beam Computed Tomography. Cleft Palate Craniofac J 2021; 59:589-594. [PMID: 34151601 DOI: 10.1177/10556656211023239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The detection of anatomical variation impairments in patients with cleft lip and palate (CLP) is crucial in combined orthodontic and maxillofacial surgical treatments. Therefore, this study aimed at evaluating the anatomical maxillary sinus characteristics, nasal septum deviation (NSD), and mucosal thickening of the maxillary sinus in patients with CLP using cone beam computed tomography (CBCT). DESIGN The CBCT images were classified into 3 groups of unilateral cleft lip and palate (UCLP; n = 40), bilateral cleft lip and palate (BCLP; n=14), and noncleft (control; n = 54). Subsequently, the maxillary sinus linear dimensions were assessed. Height, width, depth, infundibulum height, and ostium width were assessed as quantitative measures, whereas nasal septum deviation and mucosal thickening were assessed as qualitative measures. One-way analysis of variance and χ2 tests were utilized to identify any significant differences among the groups regarding the aforementioned variables. RESULTS Significant differences were observed among the groups regarding maxillary sinus height and depth, NSD, and mucosal thickening. Moreover, UCLP and BCLP groups showed higher incidence of NSD and mucosal thickening. However, the size of maxillary sinus height and depth was lower in the UCLP and BCLP groups. CONCLUSION The results showed that BCLP and UCLP groups obtained lower maxillary sinus height and depth compared to the control group. On the other hand, incidence of the NSD and mucosal thickening was significantly higher in UCLP and BCLP groups than those in the control group.
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Affiliation(s)
- Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Pourzal
- Student Research Committee, School of Dentistry, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Leila Khojastepour
- Oral and Maxillofacial Radiology, School of Dentistry, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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Cleft lip and palate cause large variations in size and location of the posterior superior alveolar canal. Clin Oral Investig 2021; 25:4451-4458. [PMID: 33417062 DOI: 10.1007/s00784-020-03757-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the posterior superior alveolar canal (PSAC) in patients with cleft lip and palate (CLP) as compared to patients with no cleft lip and palate (NC) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS This was a retrospective multicenter study based on two steps: (1) evaluating intra- and inter-calibration and (2) detecting the presence or absence of PSAC and its location, diameter, and anastomosis with anterior superior alveolar canal. RESULTS A total of 300 patients were selected for the study, out of which 150 were categorized as CLP (75 men, 75 women; mean age: 29.8 years) and 150 were categorized as NC (75 men, 75 women; mean age: 40.3 years). PSAC in patients with CLP and NC was visible in 100% of the cases, in men and women, bilaterally. PSAC location in CLP was middle and upper third of the maxillary sinus as compared to NC (lower third) (chi-squared < 0.001). PSAC mean diameter in CLP was 1.12 mm. It was larger compared to 0.6 mm in NC (t-test < 0.0001). CONCLUSION PSAC location in patients with CLP was predominantly in the middle and upper third of the maxillary sinus, compared with NC. PSAC mean diameter in CLP was 1.12 mm. It was larger compared to that of 0.6 mm in NC. CLINICAL RELEVANCE These anatomical variations in CLP are important and should be acknowledged by surgeons for the following reasons: (1) to perform pre-surgical planning, (2) to avoid bleeding, and (3) to avoid neurosensory alterations.
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Rodrigues ML, Francisco I, Caramelo F, Figueiredo JP, Vale F. A retrospective and tridimensional study of the maxillary sinus in patients with cleft lip and palate. Am J Orthod Dentofacial Orthop 2020; 159:e17-e24. [PMID: 33223375 DOI: 10.1016/j.ajodo.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Structural or anatomic differences may arise during the development of the maxillary sinus and the process of fusion of the palate in the presence of cleft lip and palate. The present study aimed to compare the maxillary sinus volume of patients with unilateral cleft lip and palate and a control group (noncleft patients). METHODS In this retrospective case-control study, 160 cone-beam computed tomography images of 80 unilateral cleft lip and palate patients (41 males and 39 females; mean age, 12.7 ± 6.03 years) and 80 control patients (43 males and 37 females; mean age, 13.1 ± 6.27 years) were evaluated through the ITK-SNAP software (Cognitica, Philadelphia, Pa) to access the maxillary sinus volume. Analysis of covariance and regression analysis were used to assess the differences between the groups while considering the relationship between maxillary sinus volume, age, and sex. RESULTS No statistically significant differences were found in the maxillary sinus volume analyzing a unilateral cleft lip and palate and a control group (P = 0.677). Considering the cleft group, there is a tendency for the maxillary sinus volume of the cleft side to be smaller than its contralateral (P < 0.001). Statistically significant differences were found in the maxillary sinus volume, regarding the age and sex of cleft and noncleft patients (P < 0.001 for age; P = 0.001 for sex). CONCLUSIONS According to these results, the presence of unilateral cleft lip and palate did not affect the maxillary sinus volume, comparing cleft and noncleft patients. A biphasic growth pattern of the maxillary sinus and a presence of sexual dimorphism were found.
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Affiliation(s)
- Mariana Latas Rodrigues
- Institute of Orthodontics, Faculty of Medicine of the University of Coimbra, University of Coimbra, Coimbra, Portugal
| | - Inês Francisco
- Institute of Orthodontics, Faculty of Medicine of the University of Coimbra, University of Coimbra, Coimbra, Portugal
| | - Francisco Caramelo
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine of the University of Coimbra, University of Coimbra, Coimbra, Portugal
| | - José Pedro Figueiredo
- Department of Stomatology, Faculty of Medicine of the University of Coimbra, University of Coimbra, Coimbra, Portugal
| | - Francisco Vale
- Institute of Orthodontics, Faculty of Medicine of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
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Wang X, Zhang M, Han J, Wang H, Li S. Three-dimensional evaluation of maxillary sinus and maxilla for adolescent patients with unilateral cleft lip and palate using cone-beam computed tomography. Int J Pediatr Otorhinolaryngol 2020; 135:110085. [PMID: 32442820 DOI: 10.1016/j.ijporl.2020.110085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/03/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Maxillary sinus disease is frequently observed in patients with unilateral cleft lip and palate (UCLP). The anatomical variations of maxillary sinus and maxilla may play a role in the high incidence of sinusitis. The aims of this study were to evaluate and compare the three-dimensional (3D) structural features of maxillary sinus and maxilla in UCLP adolescent patients between the defect and non-defect sides, and investigate the morphological relationship between the maxillary sinus and maxilla on the defect side by using cone-beam computed tomography (CBCT). METHODS CBCT images were acquired from 42 UCLP adolescent patients. Maxillary sinus and maxilla on the defect and non-defect sides were segmented respectively and assessed three dimensionally, and the comparison was performed by paired t-test. A multiple linear regression was conducted to investigate the morphological relationship between the maxillary sinus and maxilla on the defect side. RESULTS No statistically significant difference was observed in any parameter of the maxillary sinus between the defect and non-defect sides (P > 0.05). Significant differences were observed in the length, anterior width, anterior height, and volume of the maxilla between the defect side and non-defect sides (P < 0.05). The parameters of maxillary sinus were significant related to the posterior width and height of maxilla on the defect side. CONCLUSION Adolescent patients with UCLP present similar 3D structural features of the maxillary sinus on both sides. Significant differences of the maxilla between the defect and non-defect sides were displayed in the area adjacent to the defect but not showed in the posterior portion of maxilla. Certain structures of the posterior portion of maxilla contribute to the variability of maxillary sinus.
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Affiliation(s)
- Xiaoyu Wang
- Department of Stomatology, Beijing Tian Tan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, PR China; Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, PR China.
| | - Manfei Zhang
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, PR China.
| | - Jianhui Han
- Department of Radiology, Beijing Stomatological Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, PR China.
| | - Hao Wang
- Department of Stomatology, Beijing Tian Tan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, PR China.
| | - Song Li
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, PR China.
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Koparal M, Yalcın ED, Aksoy O, Ozcan-Kucuk A. Evaluation of maxillary sinus volume and surface area in children with β-thalassaemia using cone beam computed tomography. Int J Pediatr Otorhinolaryngol 2019; 125:59-65. [PMID: 31260809 DOI: 10.1016/j.ijporl.2019.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Among children with β-thalassaemia, skeletal changes and abnormalities, such as decreased volume or obliteration of the sinus, result primarily from hypertrophy and expansion of the erythroid marrow due to ineffective erythropoiesis. This study evaluated the volumes and surface areas of the maxillary sinuses of children with β-thalassaemia using cone beam computed tomography (CBCT), and compared these findings with corresponding measurements in age- and sex-matched control children. METHODS CBCT images were retrospectively evaluated for 16 children with β-thalassaemia, 19 children with a class I skeletal pattern (class I group), and 18 children with a class II skeletal pattern (class II group). After three-dimensional analyses and segmentation of each maxillary sinus, the volumes and surface areas were calculated. RESULTS The volumes and surface areas of the right (p > 0.05 and p > 0.05) and left maxillary sinuses (p > 0.05 and p > 0.05) and SNA angles (p > 0.05) were not significantly different among the groups. The ANB (p < 0.05) and SNGoMe (p < 0.05) angles were significantly greater and the SNB (p < 0.05) angle was significantly smaller in the class II and thalassaemia groups than in the class I group. CONCLUSION Children with thalassaemia tended to have lower maxillary sinus volumes and surface areas on both right and left sides, compared to those of children with class I and class II skeletal patterns; however, these differences were not statistically significant. In children with thalassaemia, a large intermaxillary discrepancy (ANB) indicated a tendency toward the class II skeletal pattern.
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Affiliation(s)
- Mahmut Koparal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Merkez, 02200, Adıyaman, Turkey.
| | - Eda Didem Yalcın
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Sehitkamil, 27410, Gaziantep, Turkey.
| | | | - Ayse Ozcan-Kucuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mersin University, 33343, Mersin, Turkey.
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Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients. Sci Rep 2019; 9:871. [PMID: 30696887 PMCID: PMC6351653 DOI: 10.1038/s41598-018-37326-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023] Open
Abstract
Trans-sutural distraction osteogenesis (TSDO) promotes midface growth in growing cleft lip and palate (CLP) patients with midfacial hypoplasia. The superficial skeletal changes after therapy revealed rotation advancement of the midfacial skeleton associated with differential displacement in each segment, but reports rarely focus on the changes of internal structures, including circummaxillary sutures, the maxillary tuberosity and the maxillary sinus, which may play a crucial role during this process. This study evaluated the computed tomographic (CT) images of 26 growing CLP patients who received bone-borne TSDO therapy. The results revealed that the most prominent new bone formation occurred in the pterygomaxillary suture and pushed the P-point forward. The maxillary first molar exhibited significantly greater advancement compared with the P-point due to the growth of the maxillary tuberosity. The contribution ratio values of the advancement of the maxillary tuberosity and P-point to the maxillary first molar were 26% and 74%, respectively, in UCLP and 25% and 75%, respectively, in BCLP. Furthermore, the maxillary sinus volume was also significantly increased. In conclusion, midface growth with bone-borne TSDO therapy depends on both secondary displacement promoted by sutural bone formation mainly in the pterygomaxillary suture and primary displacement by growth of the maxillary tuberosity and maxillary sinus volume.
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