Aberrations in Maxillary Anatomy of Adult Patients with Cleft Maxillary Hypoplasia: A Computed Tomographic Study.

Abstract

The aim of this study was to evaluate the maxillary anatomy in patients with cleft maxillary hypoplasia using computed tomogram. A cross-sectional observational study was carried out in all cleft patients reporting to our department for the correction of secondary cleft deformities. A preoperative computed tomogram of the midface (from the superior orbital rim to the maxillary occlusal plane) was recorded to assess the parameters which evaluate the maxillary and pterygomaxillary anatomy in cleft maxillary hypoplasia patients. A total of 18 adult patients (female-5; male-13) were included in the study, which includes 15 unilateral and 3 bilateral cleft lip and palate patients. All the patients had undergone palatoplasty in their early childhood. Evaluation of the circum maxillary and pterygo-maxillary anatomy on the computed tomogram revealed that the average width of maxillary tuberosity was (mean-6.91mm on cleft side, 4.51mm on noncleft side); distance between medial and lateral pterygoid plateswas (mean-6.45mm on cleft side, 5.94mm on noncleft side); distance from greater palatine foramen to posterior palatal borderwas (mean-5.6mm on cleft side, 6.1mm on noncleft side); distance from greater palatine foramen to pterygoid process was (mean-4.83mm on cleft side, 5.6mm on noncleft side); distance from pyriform rim to greater palatine foramen was (mean-30.0mm on cleft side, 31.8mm on noncleft side); inter pterygoid distance between medial pterygoid plates at the level of pterygoidhamulus was (mean-3.3cms = 33mm); inter pterygoid distance between medial pterygoid plates at skull basewas (mean-3.0 = 30mm). Maxillary hypoplasia in adult cleft patients distorts the circum maxillary and pterygomaxillary anatomy with cleft side being more hypoplastic compared to the noncleft side which needs to be evaluated prior to planning maxillary advancement.