Volumetric nasal cavity analysis in children with unilateral and bilateral cleft lip and palate.
Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls.



Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions.



We analyzed 20 subjects (age range = 7-12 years) with UCLP and BCLP from a regional craniofacial center who underwent cone beam computed tomography (CT) prior to alveolar grafting. Ten multislice CT images from age-matched controls were also analyzed. Mimics software (Materialise, Plymouth, MI) was used to create 3D reconstructions of the main nasal cavity and compute total and side-specific nasal volumes. Subjects imaged during active nasal cycling phases were excluded.



There was no statistically significant difference in affected:unaffected side volume ratios in UCLP (P = .48) or left:right ratios in BCLP (P = .25) when compared to left:right ratios in controls. Mean overall nasal volumes were 9,932 ± 1,807, 7,097 ± 2,596, and 6,715 ± 2,115 mm(3) for control, UCLP, and BCLP patients, respectively, with statistically significant volume decreases for both UCLP and BCLP subjects from controls (P < .05).



This is the first study to analyze total nasal volumes in BCLP patients. Overall nasal volume is compromised in UCLP and BCLP by approximately 30%. Additionally, our finding of no major difference in side:side ratios in UCLP and BCLP compared to controls conflicts with pre-existing literature, likely due to exclusion of actively cycling scans and our measurement of the functional nasal cavity.



3b. Laryngoscope, 126:1475-1480, 2016.
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Zainab
Z
Farzal
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Jonathan
J
Walsh
Department of Oral Diagnosis, Division of Radiology, Piracicaba Dental School, University of Campinas, Campinas, Brazil.
Gabriella
G
Lopes de Rezende Barbosa
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Carlton J
CJ
Zdanski
Department of Pediatrics, Section of Pediatric Pulmonology, Allergy, and Sleep Medicine, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Stephanie D
SD
Davis
Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Richard
R
Superfine
University of North Carolina Craniofacial Center, Chapel Hill, North Carolina, U.S.A.
Luiz A
LA
Pimenta
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Julia S
JS
Kimbell
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.|University of North Carolina Craniofacial Center, Chapel Hill, North Carolina, U.S.A.
Amelia Fischer
AF
Drake
D016022:Case-Control Studies; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002972:Cleft Palate / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D009296:Nasal Cavity / Q000000981:diagnostic imaging* / Q000473:pathology; D015508:Nasal Obstruction / Q000151:congenital / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies
Nasal volume; bilateral cleft lip and palate; unilateral cleft lip and palate