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Published on: September 19, 2015
Nasopharyngeal structure development in patients with cleft palate who underwent repair surgery
Farid Ghazi Vakili1, Masoud Nouri-Vaskeh2, Elham Eghbali3
1Department of Otorhinolaryngology, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Children with repaired cleft palate (CP) show altered nasopharyngeal (NP) development, including downward deviated maxilla and increased linear growth. However, unilateral and bilateral cleft lip and palate subtypes exhibit balanced NP growth post-surgery.
Area of Science:
- Craniofacial anatomy
- Pediatric surgery
- Orthodontics
Background:
- Cleft palate (CP) significantly impacts craniofacial development, particularly the nasopharyngeal (NP) region.
- Understanding NP bony structure development in CP patients is crucial for surgical and orthodontic interventions.
Purpose of the Study:
- To compare the developmental characteristics of the bony nasopharyngeal (NP) region in children with cleft palate (CP) and non-cleft subjects.
- To evaluate the impact of CP subtypes on NP development.
Main Methods:
- Lateral cephalograms of 64 non-syndromic CP patients and 23 controls were analyzed.
- Key points (Hormion, posterior maxillary point, anterior atlas point) were used to measure anterior-posterior and vertical dimensions, linear growth, and area of the NP.
- Measurements were compared between CP subgroups and controls.
Main Results:
- Isolated CP subgroup showed significantly greater downward development of the posterior maxillary region (PMP), increased cranial-maxillary linear growth (Ho-PMP), and larger NP area compared to controls.
- No significant differences in NP dimensions or area were found between unilateral cleft lip and palate (UCLP) or bilateral CLP groups and the control group.
Conclusions:
- Repaired CP patients exhibit a downward deviated posterior maxilla, increased cranial-maxillary linear growth, and larger NP area compared to normal subjects.
- UCLP and BCLP subtypes demonstrated balanced NP growth post-repair, suggesting successful surgical outcomes for normal development in these cases.
Objective:
This study aimed to compare the developmental characteristics of bony nasopharyngeal (NP) in children with cleft palate (CP) and non-cleft subjects.
Methods:
This study was conducted on 64 non-syndromic CP patients who underwent repair surgery and 23 non-cleft subjects as controls. Lateral cephalograms were performed on participants at rest in the natural head position. The X-coordinate and the Y-coordinate of three points on cephalograms were determined as Hormion (Ho), posterior maxillary point (PMP) and anterior point of the atlas (At) representing the anterior-posterior (AP) and vertical dimension of the NP. The linear dimension of the NP (i.e. Ho-At, Ho-PMP, At-PMP) and its area was also calculated.
Results:
The bony structures of NP in the clef-affected subjects in isolated CP subgroup, had a significantly greater downward development in the maxillary region (PMP) (both with p = 0.001), more linear growth in cranial-maxillary (Ho-PMP) dimension (p = 0.017 and 0.004, respectively), and larger area (p = 0.017 and <0.001, respectively), when compared to normal subjects. There was no significant difference between either the unilateral cleft lip and palate (CLP) or bilateral CLP group with the control group regarding AP, vertical, and linear growth of the NP and its area (P > 0.05).
Conclusions:
Patients with repaired CP had downward deviated posterior maxilla, more linear growth in cranial-maxillary dimension and larger area compared to normal subjects. Among CP subtypes, a balanced growth was observed among repaired UCLP and BCLP patients, suggesting that with appropriate repaired surgery, normal development of the NP region could be expected in these subtypes.
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