Abstract

IntroductionChildren with cleft lip and palate (CLP) are known to have airway problems. Previous studies have shown that individuals with CLP have a 30% reduction in nasal airway size compared to non-cleft controls. No reports have been found on cross-sectional area and volume of the pharyngeal airway in clefts. Introduction of Cone-Beam CT (CBCT) and imaging software has facilitated generation of 3D images for assessment of the cross-sectional area and volume of the airway.ObjectiveTo assess the pharyngeal airway in individuals with CLP using CBCT by measuring volume and smallest cross-sectional areas and compare with 19 age- and sex-matched non-cleft controls.MethodsRetrospective study of CBCT data of pre-adolescent individuals (N = 19, Mean age = 10.6, 7 females, 12 males, UCLP = 6, BCLP = 3) from the Center for Craniofacial Anomalies. Volumetric analysis was performed using image segmentation features in CB Works 3.0. Volume and smallest cross-sectional were studied in both groups. Seven measurements were repeated to verify reliability using Pearson correlation coefficient. Volume and cross-sectional area differences were analyzed using paired t-tests.ResultsThe method was found to be reliable. Individuals with CLP did not exhibit smaller total airway volume and cross sectional area than non-CLP controls.Conclusion3D imaging using CBCT and CB Works is reliable for assessing airway volume. Previous studies have shown that the nasal airway is restricted in individuals with CLP. In our study, we found that the pharyngeal airway is not compromised in these individuals.

Highlights

  • Children with cleft lip and palate (CLP) are known to have airway problems

  • 3D imaging using Cone-Beam Computed Tomography (CT) (CBCT) and CB Works is reliable for assessing airway volume

  • We found that the pharyngeal airway is not compromised in these individuals

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Summary

Introduction

Children with cleft lip and palate (CLP) are known to have airway problems. Previous studies have shown that individuals with CLP have a 30% reduction in nasal airway size compared to non-cleft controls. Orofacial defects like cleft lip and/or palate (CLP) occur in an estimated 6,800 children annually, making it the most common birth defect in the United States [2]. CLP are frequently associated with nasal abnormalities such as septal deviation, nostril atresia, turbinate hypertrophy, maxillary constriction, vomerine spurs, and alar constriction [4,5,6,7,8]. These abnormalities are attributed in part to the congenital defect itself and partly to the surgeries done to repair the orofacial defect [9,10]. The nasal abnormalities tend to reduce the dimensions of the nasal cavity and lower airway function [6,11]

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