A Three-Dimensional Computed Tomographic Analysis of the Cervical Spine in Unoperated Infants with Cleft Lip and Palate

2006 ◽  
Vol 43 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Asilah Yusof ◽  
...  

Objective: To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate. Design: Retrospective cross-sectional investigation of infants born with nonsyndromic cleft lip and palate using computed tomography scans acquired for investigation of a spectrum of clinical conditions. Setting: Computed tomography scan data were obtained from 29 unoperated cleft lip and palate infants and 12 noncleft infants of Malay origin, ages 0 to 12 months. Methods: Observational study of cervical spine computed tomography scans. Heights of cervical vertebral bodies (C2-C7) and intervertebral spaces were measured from landmarks identified from computed tomography reformats and three-dimensional computed tomography reconstructions. Linear modeling of heights and spaces, with age as a covariate, was undertaken to identify differences between the samples. Results: Anomalous features observed in the cleft lip and palate sample included short posterior arch of C1 (2/29), abnormal development of the anterior arch of C1 (2/29), and fusions of the posterior arch of C2 and C3 (2/29). No anomalies of the cervical spine were observed in the noncleft sample. Although the heights of three cervical vertebral bodies were significantly smaller and two intervertebral spaces were significantly larger in infants with cleft lip and palate compared with noncleft infants (p < .05), overall length of the cervical spine did not differ significantly between the samples. Conclusion: There was evidence for subtle upper spinal anomalies in the infant cleft lip and palate population. Our finding of reduced size of some cervical vertebral bodies may reflect delayed upper spinal development in infants with cleft lip and palate.

2006 ◽  
Vol 43 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Toby Hughes ◽  
...  

Objective: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. Design: Retrospective, cross sectional. Patients and Methods: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. Results: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. Conclusion: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation.


2020 ◽  
Vol 32 (1) ◽  
pp. e15-e19
Author(s):  
Renan Jhordan Mettelziefen dos Inocentes ◽  
Maria Noel Marzano-Rodrigues ◽  
Guilherme Gonçalves de Espíndola ◽  
Michele García-Usó ◽  
Marília Sayako Yatabe-Ioshida ◽  
...  

2008 ◽  
Vol 45 (5) ◽  
pp. 511-517 ◽  
Author(s):  
Lynn M. Seidenstricker-Kink ◽  
Devra B. Becker ◽  
Daniel P. Govier ◽  
Valerie B. DeLeon ◽  
Lun-Jou Lo ◽  
...  

Objective: To quantify comparative improvement between osseous and soft tissue asymmetry following primary lip repair. Design: Retrospective analysis of preoperative and postoperative computed tomography scans of infants with unilateral cleft lip and palate. Sixteen soft tissue landmarks were placed using an exploratory two-/three-dimensional image processing system and compared for asymmetry. Patients: Computed tomography scans were obtained on 26 patients (13 boys, 13 girls) of Chinese ethnicity (mean age  =  0.25 years) prior to Millard lip repair. Nineteen of these contributed to follow-up comparative studies prior to palatoplasty at a mean age of 0.92 years. There were 18 left-sided and eight right-sided clefts. Main Outcome Measure: Euclidean distance matrix asymmetry analysis was used to determine the amount of soft tissue asymmetry pre- and postlip repair. Similar analyses of the same scans were performed for 41 osseous landmarks. Results: Soft tissue landmarks had 36/39 (92%) preoperative and 13/39 (33%) postoperative asymmetric pairs. Osseous distances demonstrated 77/125 (61%) asymmetric pairs preoperatively and 60/125 (48%) postoperatively. Soft tissue and osseous distances of the lip region demonstrated 32% and 39% postoperative asymmetry, respectively. Soft tissue and osseous distances of the nasal region demonstrated 52% and 72% postoperative asymmetry, respectively. Soft tissue and osseous distances of the facial landmarks demonstrated 24% and 34% postoperative asymmetry, respectively. Conclusions: Primary lip repair appears to effect gains in symmetry in soft tissue and provides sufficient molding forces to cause correlating symmetry changes in underlying osseous structures.


Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.


2009 ◽  
Vol 46 (4) ◽  
pp. 399-408 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Jana Velemínská ◽  
Pavel Trefný ◽  
Živa Müllerová

Objective: Three-dimensional analysis of palate size and shape in 30 patients with complete bilateral cleft lip and palate (BCLPc) at the stage of permanent dentition. Design: Cross-sectional study based on laser scanning. Subjects: Thirty dental casts of boys approximately 15 years old with BCLPc and 28 dental casts of healthy boys of the same age. Interventions: Arched-lip suture with periosteoplasty and push-back of the palate with pharyngeal-flap surgery. Main Outcome Measures: Data on palate height in the 210 defined locations and on palate widths and profile area in 10 transverse sections. Results: The palate in patients with BCLPc was conical and narrower than in control study subjects, much more anteriorly than posteriorly. From the canines posteriorly, the palate was of almost constant height of 10 mm in the midline, being higher than in control study subjects at this location and lower more posteriorly (by 24% to 29% between molars). The area of transverse sections was reduced as compared with control study subjects from the first premolars posteriorly and reached more than 40% between molars. The length of the palate up to the first molars was not changed. Conclusion: BCLPc subjects exhibited narrow, low, and flat palate. Palate size and shape differences indicate a substantial reduction of the space for the tongue.


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