Rhinologic computed tomographic evaluation in patients with cleft lip and palate.
OBJECTIVE
To investigate the anatomical characteristics of the nasal cavity and paranasal sinuses in relation to the presence of sinusitis in patients with cleft lip and palate.


METHODS
Retrospective survey.


METHODS
Tertiary care hospital.


METHODS
Forty-seven consecutive patients with cleft lip and alveolus with or without cleft palate.


METHODS
The patients underwent computed tomographic scans of the maxilla, and the following parameters were evaluated: nasal septal shift from the midline, soft tissue density shadow of the maxillary sinus, cross-sectional area of the maxillary sinus, and height of the floor of the maxillary sinus.


RESULTS
The nasal septum was convex to the cleft side in most of the patients with unilateral clefts, and there was a significant correlation between the cleft side and the direction of nasal septal deviation (P<.001). Sinusitis was more severe in the noncleft side than in the cleft side (P =.04), and in the concave side than in the convex side (P= .02). The cross-sectional area of the maxillary sinus was not statistically different between the cleft side and noncleft side, nor between the septal concave side and convex side. The floor of the maxillary sinus was situated higher in the cleft side than in the noncleft side (P = .02).


CONCLUSIONS
The occurrence of maxillary sinusitis associated with cleft lip and palate is dependent on both the cleft side and the deviated nasal septum, but not on the size of the sinus. The cleft side is responsible for the direction of the septal deviation and the height of the floor of the maxillary sinus. A low-situated sinus floor may be in contact with the root of the teeth, and thus may be one of the etiologic factors of sinusitis in patients with clefts.
Suzuki
H
H
Department of Otolaryngology, Sendai National Hospital, Japan. suzuhyde@mb.infoweb.or.jp
Yamaguchi
T
T
Furukawa
M
M
D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000000981:diagnostic imaging* / Q000601:surgery; D002972:Cleft Palate / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000601:surgery; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D009300:Nasal Septum / Q000000981:diagnostic imaging / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed