title: Inferior Turbinate Asymmetry Is a Feature of the Unilateral Complete Cleft Lip and Palate Nasal Deformity.
abstract: OBJECTIVE
  Patients with unilateral complete cleft lip and palate (UCLP) have a characteristic bilateral septal deformity, and septal deviation can be associated with turbinate hyperplasia, leading to paradoxical nasal obstruction. The purpose of the present study was to measure and compare the bony and mucosal dimensions of the inferior turbinate on the cleft and non-cleft sides in patients with UCLP.
  
  
  METHODS
  We implemented a retrospective cohort study of patients with UCLP who had undergone computed tomography (CT) scan between 2002 to 2013. Subjects who had undergone nasal revision, septoplasty, turbinectomy, or Le Fort I osteotomy before the imaging date were excluded. The primary predictor variable was the subject side (cleft vs noncleft side), and the primary outcome variable was the turbinate cross-sectional area. The secondary predictor variables included the site of measurement along the sagittal axis of the turbinate (anterior, middle, posterior) and tissue type (turbinate whole, bone, mucosa). The Wilcoxon signed rank test for paired samples compared the turbinate dimensions on the cleft and noncleft sides, with statistical significance set at P ≤ .05.
  
  
  RESULTS
  The sample included 53 patients (32 females and 21 males). The inferior turbinates were measured bilaterally on CT images obtained at a mean age of 12.2 ± 0.8 years. The inferior turbinate on the noncleft side was significantly larger in both bone and mucosa (P = .003). This relationship did not change when controlling for age and gender.
  
  
  CONCLUSIONS
  The results of the present study have confirmed bony and mucosal enlargement of the inferior turbinate on the noncleft side in patients with UCLP. This might contribute to bilateral nasal obstruction and should be considered during treatment planning for nasopharyngeal and orthognathic surgery.
authors.affiliation: Clinical Research Fellow, Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Kelley M
authors.initials: KM
authors.lastname: Dentino
authors.affiliation: Dental Student, Harvard School of Dental Medicine, Boston, MA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sierra-Vasquez
authors.affiliation: Associate Professor, Harvard School of Dental Medicine, Oral Surgeon in Chief, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA. Electronic address: Bonnie.Padwa@childrens.harvard.edu.
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Padwa
mesh_terms: D000293:Adolescent; D019412:Anatomy, Cross-Sectional / Q000379:methods; D002508:Cephalometry / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000473:pathology*; D002972:Cleft Palate / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D006984:Hypertrophy; D008297:Male; D009295:Nasal Bone / Q000002:abnormalities; D009297:Nasal Mucosa / Q000473:pathology; D009300:Nasal Septum / Q000002:abnormalities; D009666:Nose / Q000002:abnormalities*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D014420:Turbinates / Q000002:abnormalities*