Prelacrimal recess morphology in unilateral cleft lip and palate: A cone-beam computed tomography study with surgical...

Cleft lip and palate(CLP) is a deformity that affects the anatomical structure of the nose and the maxillary sinus(MS). In the management of MS pathologies, the prelacrimal recess approach(PLRA), a minimally invasive technique within endoscopic sinus surgery, holds significant importance. This study aims to evaluate the morphometric characteristics of the nasolacrimal duct(NLD) and the prelacrimal recess(PLR), as well as the feasibility of the prelacrimal recess approach(PLRA), in patients with unilateral cleft lip and palate(UCLP) using cone-beam computed tomography(CBCT). CBCT images of both the cleft and non-cleft sides of 60 patients with UCLP were retrospectively analyzed. Morphometric measurements related to the anatomy of the NLD and the PLR were performed and statistically compared.In these patients, the mediolateral diameter of the NLD was found to be significantly narrower on the cleft side(5.10 ± 1.29 mm) compared to the non-cleft side(5.74 ± 1.28 mm)(p = 0.03). The mediolateral thickness of the PLR was also significantly thinner on the cleft side(1.89 ± 1.46 mm) than on the non-cleft side(2.91 ± 1.95 mm)(p = 0.01). However, no significant difference was observed in the anteroposterior length of the PLR between the cleft side(5.08 ± 2.54 mm) and the non-cleft side(4.64 ± 2.67 mm)(p = 0.35).The prelacrimal recess and nasolacrimal canal on the cleft side may be affected in patients with UCLP. CBCT serves as a valuable tool in identifying these anatomical variations, which are frequently associated with congenital deformities such as UCLP and should be carefully considered during surgical planning.