Prevalence of cervical vertebrae anomalies in patients with cleft lip and palate

Om Prakash Kharbanda,Devasenathipathy Kandasamy,Tabassum Qureshi

doi:10.21307/aoj-2020-032

Om Prakash Kharbanda, Devasenathipathy Kandasamy + Show 1 more

Open Access

https://doi.org/10.21307/aoj-2020-032

Copy DOI

Abstract

Abstract Objective To investigate the prevalence of cervical vertebral anomalies (CVA) in a group of patients presenting with cleft lip and palate (CLP) and to compare with a non-cleft population. Material and methods The sample comprised of 150 lateral cephalograms of non-syndromic patients with CLP and 150 non-cleft age-matched controls. The age range of both groups covered 6 to 20 years. An expert radiologist blinded to the cleft status evaluated the cephalograms for CVA and categorised them into normal, fusion, dehiscence and multiple cervical anomalies. The cleft group was subdivided according to the types of cleft (UCLP/ BCLP/ CPO) and gender (male/female). The CVA prevalence was compared between the cleft and non-cleft patients. Results The prevalence of CVA was 37.7% and 20.7% in cleft and non-cleft patients, respectively. The difference was statistically significant with a p-value <0.01. Of the types of clefts, a left UCLP had the highest prevalence of CVA (47.2%), with fusion (35.8%) most commonly seen. On comparing CLP with CPO, no significant variation was observed between the types of anomalies. Conclusions A high prevalence of CVA was observed in cleft patients compared with non-cleft subjects. The prevalence of CVA was similar between males and females. The practitioner should carefully evaluate the lateral cephalogram of CLP patients for CVA, which otherwise may remain undetected and lead to neurological symptoms later in life.

Highlights

The lateral cephalogram is an essential diagnostic record routinely advised in orthodontic practice
The current retrospective study was performed on lateral cephalograms available from the archives of the postgraduate department of orthodontics and cleft lip and palate clinic
A review of the literature[10] showed approximately 20% of cleft cases and 6% of non-cleft cases had cervical vertebrae anomalies (CVA) detected in their lateral cephalograms

Summary

Introduction

The lateral cephalogram is an essential diagnostic record routinely advised in orthodontic practice. The cervical vertebral maturation index is used to predict the growth status of patients,[1] anatomical deviations in the morphology of the upper cervical spine may remain unrecognised. A lateral cephalogram offers significant diagnostic value in recording aberrations in the morphology of the cervical spine. Cervical vertebral anomalies can present with myelopathy, cause limitation in neck movement, muscular atrophy, and regional sensory loss.[2] Early diagnosis of cervical vertebrae anomalies (CVA) is critical in determining the risk of associated diseases at the time of presentation in young patients and the Australasian Orthodontic Journal Volume 35 No 1 May 2019 occurrence of secondary neurological symptoms later in life. CVA develop during early intrauterine life due to a combination of genetic and environmental factors.

Methods

Results

Conclusion