Computed axial tomographic assessment of cranioorbital anatomy in unilateral clefts

Anatomy of the cranioorbital region in the unoperated infant with cleft lip/palate, is not well known. In this study, computed axial tomography was performed in 7 infants with unoperated unilateral cleft lip combined with cleft palate but no recognized craniofacial syndromes, and on 5 age-matched control infants. Significant differences were found between the infants with cleft lip/palate and the normal infants. There was more plagiocephaly in the cleft group, and the flattened forehead on the involved side was associated with less facial projection. The angles of the petrous portions of the temporal bones and midsagittal plane were also significantly more obtuse in the cleft group. In the normal group the lateral orbital walls and petrous portions of the temporal bones formed a large symmetrical X. This X in the cleft groups was distorted and not readily recognizable. There were also trends indicating possible differences in the orbital and ethmoid orientations in the two groups.