Morphometric Analysis of the Infraorbital Foramen in Children and Adolescents with Unilateral Cleft Lip and Palate: A...

Aim: A precise understanding of the morphometric characteristics of the infraorbital foramen (IOF) is essential for ensuring safe and effective surgical interventions and regional anesthesia in children and adolescents with cleft lip and palate (CLP). This study aimed to investigate the morphometric characteristics of the IOF using CBCT in children and adolescents with unilateral cleft lip and palate (UCLP) and to compare the cleft side (CS) with the non-cleft side (NCS). Materials and Method: CBCT scans of 48 individuals with UCLP were analyzed, evaluating a total of 96 IOFs. Reference anatomical landmarks included the supraorbital margin (SOM), infraorbital margin (IOM), nasion (N), anterior nasal spine (ANS), tuber maxilla (TM), sella (S), lateral margin of the apertura piriform (LAP), jugale (J), and midline (M). Distances from the IOF to these landmarks were measured and compared between the CS and NCS. Soft tissue thickness over the IOF was also assessed, and the IOF shape was evaluated separately for each side. Results: The V-oval form was the most common IOF shape on both sides. No significant differences were found in vertical or horizontal diameters between the CS and NCS (p > 0.05). Distances from the IOF to IOM, SOM, S, N, LAP, and midline were significantly shorter on the CS (p < 0.05), whereas distances to ANS and J were significantly longer on the CS (p < 0.05). No significant differences were observed in IOF-TM distances or soft tissue thickness (p > 0.05). Conclusions: In individuals with UCLP, the IOF exhibits significant side-specific variations relative to key anatomical landmarks. These differences should be considered in infraorbital nerve block administration and surgical planning to improve accuracy and safety.