Three-Dimensional Morphometric Evaluation of the Upper Airway in Infants with Cleft Palate
Shijiao Lu1, Qinlin Sun2,3, Fubing Yang3
1Department of Pediatric Surgery, Jiaxing Women and Children's Hospital Affiliated with Wenzhou Medical University, No. 2468 Central East Road, Nan hu District, Jiaxing, 314000 Zhejiang China.
Insights
Infants with cleft palate have smaller upper airways, particularly the oropharynx. Oropharyngeal volume is key to airway issues in these infants, not adenoid thickness or hyoid vertebral distance.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Otolaryngology
Background:
- Advancing surgical and anesthetic techniques enable earlier cleft palate surgeries in infants.
- Early surgery increases the risk of airway complications such as obstruction and edema.
- Preoperative evaluation of the upper airway is critical for infants with cleft palate.
Purpose of the Study:
- To investigate the three-dimensional morphology of the upper airway in infants with cleft palate.
- To compare upper airway dimensions in infants with and without cleft palate.
- To identify key anatomical factors influencing airway patency in infants with cleft palate.
Main Methods:
- Reconstructed three-dimensional upper airway models from 22 infants with cleft palate.
- Measured maxillofacial bone morphology, total upper airway volume, nasopharyngeal volume, and oropharyngeal volume.
- Analyzed hyoid vertebral distance (HVD) and adenoid thickness (AT) in relation to airway dimensions.
Main Results:
- Infants with cleft palate exhibited significantly reduced total upper airway and oropharyngeal volumes compared to controls.
- Nasopharyngeal volume did not significantly differ between groups.
- Craniofacial morphology measurements were significantly smaller in infants with cleft palate, but HVD and AT showed no significant differences.
Conclusions:
- Oropharyngeal volume is the primary determinant of upper airway compromise in infants with cleft palate.
- Adenoid thickness and hyoid vertebral distance are not significant factors in this cohort.
- Understanding these morphological differences is crucial for managing airway risks in infants undergoing cleft palate repair.
Introduction:
As surgical and anesthetic techniques advance, more infants with cleft palates undergo surgery at earlier ages. This progress, however, is accompanied by an increased risk of airway complications like obstruction and edema. Consequently, thorough preoperative evaluation of the upper airway in cleft palate patients is crucial.
Objective:
To explore the three-dimensional morphology of the upper airway in infants with cleft palate.
Materials And Methods:
Twenty-two patients diagnosed with cleft palate were examined, and upper airway models were reconstructed. The maxillofacial bone morphology and total volume of the upper airway, nasopharynx and oropharynx were measured. The hyoid vertebral distance (HVD) and adenoid thickness (AT) were analyzed together. P<0.05 was considered to indicate statistical significance.
Results:
The total volume of the upper airway and the oropharyngeal volume in cleft palate infants were significantly lower than those in normal infants, whereas the nasopharyngeal volume was not significantly different. The measurements of craniofacial morphology in cleft palate infants were significantly lower than those in normal infants. Nevertheless, there was no significant difference in HVD or AT.
Conclusion:
Oropharyngeal volume, other than AT volume and HVD volume, is the main factor affecting the airway in infancy with cleft palate.
