Three-Dimensional Morphological Evaluation of the Maxillary Sinus in Individuals With Cleft Lip and Palate and...

Maxillary sinus morphology plays a crucial role in surgical planning and postoperative outcomes in patients with cleft lip and palate (CLP). Anatomical variations may affect sinus development and may differ from non-CLP.

This study aimed to compare maxillary sinus morphology in nonsyndromic CLP subjects and noncleft control subjects with skeletal Class I, II, and III malocclusions using cone-beam computed tomography (CBCT).

This was a retrospective cross-sectional study comprising patients who presented to the Gazi University Faculty of Dentistry for the evaluation and management of maxillofacial deformities. Exclusion criteria were incomplete maxillary sinus imaging, prior posterior maxilla surgery/pathology, and craniofacial syndromes.

The predictor variable was categorized into 4 groups: skeletal Class I, skeletal Class II, skeletal Class III, and CLP.

The outcome variable was maxillary sinus morphology. Based on CBCT imaging, sinus morphology was evaluated using volume, height, and width measurements as primary outcomes. Secondary outcomes included ostium width, septum presence and deviation, Haller cells, mucosal thickness, sinus angle, and buccolingual wall thickness.

Covariates included age, sex, and cleft laterality (unilateral or bilateral) for the CLP group.

Descriptive statistics were followed by Mann-Whitney U tests and Tukey post hoc tests for pairwise comparisons. Pearson and Spearman correlation coefficients were used to evaluate relationships between continuous variables. Statistical significance was set at P < .05.

The study included 80 subjects (mean age: 25.36 ± 6.88 years), of whom 36 (45.0%) were male. Mean maxillary sinus volume was the smallest in the CLP group (12.01 ± 3.48 mm³) and largest in the Class III group (16.48 ± 4.28 mm³) (P < .001). The mean sinus height ranged from 33.08 ± 6.00 mm (Class II) to 38.26 ± 5.19 mm (Class III) (P = .001). Septal deviation angle was significantly greater in the CLP group (13.04 ± 4.33°) (P < .001). The sinus angle was smallest in the CLP group (76.16 ± 9.36°).

CBCT-based comparison revealed modest but clinically relevant differences in maxillary sinus morphology among individuals with CLP and those with skeletal Class I, Class II, or Class III. Reduced sinus volume, increased mucosal thickness, and greater septal deviation in CLP patients may be relevant for preoperative assessment and surgical planning involving the maxillary sinus.