Amaç: Dudak damak yarığı (DDY), konjenital gelişimsel anomalilerden biridir. Çalışmamızın amacı, nonsendromik unilateral DDY olan hastalar ile DDY olmayan hastaların (kontrol grubu) konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri ile maksiller sinüs hacmi (MSH), nazal septum deviasyonu (NSD) ve konka bülloza varlığının değerlendirilerek olası ilişkilerin tespitidir. Gereç ve Yöntemler: Nonsendromik unilateral DDY olan 30 (11 kadın-19 erkek; ortalama yaş: 14,50±4,28 yıl) hasta ve 30 (15 kadın-15 erkek; ortalama yaş: 16,30±4,79 yıl) DDY olmayan hastanın KIBT görüntüleri arşivden retrospektif olarak seçilmiştir. MSH (sağ-sol), NSD varlığı, deviasyon yönü ve konka bülloza varlığı her birey için değerlendirilmiştir. Elde edilen veriler SPSS v.22 kullanılarak tanımlayıcı istatistikler, bağımsız örneklem t-testi, eşleştirilmiş örneklem t-testi ve ki-kare testi ile analiz edilmiştir. Bulgular: DDY gözlenen grubun tamamında NSD tespit edilmiştir. DDY; 15 hastada sağda 15 hastada solda gözlenmiştir. Sağ taraf DDY'nin 12'sinde (%80) sağa NSD, sol taraf DDY'nin ise tamamında sola NSD görülmüştür. DDY varlığı ile NSD varlığı arasında istatistiksel olarak anlamlı ilişki tespit edilmiştir (p=0,000). Kontrol grubunda MSH; sağda 9,84±4,37 mm3 , solda 9,86±4,31 mm3 olup aralarında anlamlı bir fark gözlenmemiştir (p=0,780). DDY gözlenen grupta; yarık taraf MSH (6,52±3,79 mm3 ) ile yarık olmayan taraf MSH (9,36±4,14 mm3 ) arasında istatistiksel olarak anlamlı bir fark gözlenmiştir (p=0,000). DDY ile konka bülloza varlığı arasında istatistiksel olarak anlamlı ilişki tespit edilmemiştir (p>0,05). Sonuç: DDY hastalarında kontrol grubuna göre daha fazla NSD, yarık taraf MSH'de yarık olmayan tarafa göre anlamlı bir azalma gözlenmiş olup, çalışma sonuçları DDY hastalarının teşhis, tedavi ve cerrahi sürecine katkı sağlayabilir.
Anahtar Kelimeler: Dudak damak yarığı; nazal septum deviasyonu; maksiller sinüs hacmi; konik ışınlı bilgisayarlı tomografi
Objective: Cleft lip and palate (CLP) is one of the congenital developmental anomalies. The aim of the present study was to determine possible relationships by evaluating the maxillary sinus volume (MSV), the presence of nasal septum deviation (NSD), and concha bullosa on cone-beam computed tomography (CBCT) images of patients with non-syndromic unilateral CLP and patients without CLP (control group). Material and Methods: CBCT images of 30 (11 females-19 males; mean age: 14.50±4.28 years) patients with non-syndromic unilateral CLP and 30 patients without CLP (15 female-15 male; mean age: 16.30±4.79 years) were selected retrospectively from the archive. Data set was created by evaluating MSV (right-left), presence of NSD, deviation direction and presence of concha bullosa for each individual. The obtained data were analyzed with descriptive statistics, independent sample t-test, paired sample t-test and chi-square test using SPSS v.22. Results: NSD was detected in the entire group with CLP. CLP was observed on the right in 15 patients and on the left in 15 patients. Right NSD was seen in 12 (80%) of right sided CLP, and left NSD was seen in all leftsided CLP. A statistically significant relationship was found between the presence of CLP and NSD (p=0.000). In the control group; no significant difference (p=0.780) was observed between right (9.84±4.37 mm3 ) and left (9.86±4.31 mm3 ) MSV. In the CLP group, the statistically significant difference was observed between cleft side (6.52±3.79 mm3 ) and non-cleft side (9.36±4.14 mm3 ) MSV (p=0.000). No statistically significant correlation was found between the presence of CLP and the presence of concha bullosa (p>0.05). Conclusion: In CLP patients, more NSD was observed than in the control group and a significant decrease in MSV on the cleft side compared to the non-cleft side was observed, and the results of the study may contribute to the diagnosis, treatment, and surgical process of CLP patients.
Keywords: Cleft lip and palate; nasal septum deviation; maxillary sinus volume; cone-beam computed tomography
- Lawson W, Patel ZM, Lin FY. The development and pathologic processes that influence maxillary sinus pneumatization. Anat Rec (Hoboken). 2008;291(11):1554-63. [Crossref] [PubMed]
- Demirtas O, Kalabalik F, Dane A, Aktan AM, Ciftci E, Tarim E. Does unilateral cleft lip and palate affect the maxillary sinus volume? Cleft Palate Craniofac J. 2018;55(2):168-72. [Crossref] [PubMed]
- Erdur O, Ucar FI, Sekerci AE, Celikoglu M, Buyuk SK. Maxillary sinus volumes of patients with unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol. 2015;79(10):1741-4. [Crossref] [PubMed]
- Ishikawa Y, Kawano M, Honjo I, Amitani R. The cause of nasal sinusitis in patients with cleft palate. Arch Otolaryngol Head Neck Surg. 1989;115(4):442-6. [Crossref] [PubMed]
- Lopes de Rezende Barbosa G, Pimenta LA, Pretti H, Golden BA, Roberts J, Drake AF, et al. Difference in maxillary sinus volumes of patients with cleft lip and palate. Int J Pediatr Otorhinolaryngol. 2014;78(12):2234-6. [Crossref] [PubMed]
- Koppe T, Weigel C, Bärenklau M, Kaduk W, Bayerlein T, Gedrange T. Maxillary sinus pneumatization of an adult skull with an untreated bilateral cleft palate. J Craniomaxillofac Surg. 2006;34 Suppl 2:91-5. [Crossref] [PubMed]
- Emirzeoglu M, Sahin B, Bilgic S, Celebi M, Uzun A. Volumetric evaluation of the paranasal sinuses in normal subjects using computer tomography images: a stereological study. Auris Nasus Larynx. 2007;34(2):191-5. [Crossref] [PubMed]
- Suzuki H, Yamaguchi T, Furukawa M. Rhinologic computed tomographic evaluation in patients with cleft lip and palate. Arch Otolaryngol Head Neck Surg. 1999;125(9):1000-4. [Crossref] [PubMed]
- Robinson HE, Zerlin GK, Passy V. Maxillary sinus development in patients with cleft palates as compared to those with normal palates. Laryngoscope. 1982;92(2):183-7. [Crossref] [PubMed]
- Hikosaka M, Nagasao T, Ogata H, Kaneko T, Kishi K. Evaluation of maxillary sinus volume in cleft alveolus patients using 3-dimensional computed tomography. J Craniofac Surg. 2013;24(1):e23-6. [Crossref] [PubMed]
- Yılmaz S, Amuk M. Unilateral dudak damak yarıklı hastalarda maksiller sinüs hacim ve yüzey alanının konik ışınlı bilgisayarlı tomografi kullanılarak değerlendirilmesi [Evaluation of the maxillary sinus volume and surface area in patients with unilateral lip and palate cleft using cone beam computed tomography]. AÜDHF Dergisi. 2021;31(1):1-7. [Crossref]
- Francis P, Raman R, Korula P, Korah I. Pneumatization of the paranasal sinuses (maxillary and frontal) in cleft lip and palate. Arch Otolaryngol Head Neck Surg. 1990;116(8):920-2. [Crossref] [PubMed]
- Schneiderman ED, Xu H, Salyer KE. Characterization of the maxillary complex in unilateral cleft lip and palate using cone-beam computed tomography: a preliminary study. J Craniofac Surg. 2009;20 Suppl 2:1699-710. [Crossref] [PubMed]
- Tarım Ertaş E, Kalabalık F. Bir Türk örneklem grubunda dental volumetrik tomografi endikasyonları [The indications for dental volumetric tomography in a Turkish population sample]. AÜDHF Dergisi. 2015;24(2):232-40. [Crossref]
- Akbulut A, Demirel O. Nazal septum deviasyonu ve konka bulloza ilişkisinin konik ışınlı bilgisayarlı tomografi ile değerlendirilmesi [Evaluation of relationship between nasal septum deviation and concha bullosa using cone beam computed tomography]. Selcuk Dent J. 2019;6(4):31-6. [Link]
- Drettner B. The nasal airway and hearing in patients with cleft palate. Acta Otolaryngol. 1960;52:131-42. [Crossref] [PubMed]
- Sandham A, Murray JA. Nasal septal deformity in unilateral cleft lip and palate. Cleft Palate Craniofac J. 1993;30(2):222-6. [Crossref] [PubMed]
- Göksel S, Çakır Karabaş H, Güray B, Taşyapan SA, Özcan İ. Konka bülloza görülme sıklığının konik ışınlı bilgisayarlı tomografi ile analizi ve maksiller sinüzit ile ilişkisi [Analysis of the frequency of concha bullosa using cone beam computed tomogrphy and relationship with maxillary sinusitis]. AÜDHF Dergisi. 2020;47(1-3):45-9. [Link]
- Ali IK, Sansare K, Karjodkar FR, Vanga K, Salve P, Pawar AM. Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance. Imaging Sci Dent. 2017;47(1):33-7. [Crossref] [PubMed] [PMC]
- Göksel S. Konik ışınlı bilgisayarlı tomografi kullanılarak osteomeatal kompleksin anatomik varyasyonlarının dudak damak yarıklı hastalar ile sağlıklı popülasyon karşılaştırılarak retrospektif olarak değerlendirilmesi [Uzmanlık tezi]. İstanbul: İstanbul Üniversitesi; 2019. Erişim Tarihi: 21.11.2022 [Link]
- Aksoy U, Orhan K. Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study. Clin Oral Investig. 2019;23(1):123-31. [Crossref] [PubMed]
- Massie JP, Runyan CM, Stern MJ, Alperovich M, Rickert SM, Shetye PR, et al. Nasal Septal anatomy in skeletally mature patients with cleft lip and palate. JAMA Facial Plast Surg. 2016;18(5):347-53. [Crossref] [PubMed]
- Ishikawa Y, Amitani R. Nasal and paranasal sinus disease in patients with congenital velopharyngeal insufficiency. Arch Otolaryngol Head Neck Surg. 1994;120(8):861-5. [Crossref] [PubMed]
- Suzuki H, Yamaguchi T, Furukawa M. Maxillary sinus development and sinusitis in patients with cleft lip and palate. Auris Nasus Larynx. 2000;27(3):253-6. [Crossref] [PubMed]
- Aras I, Olmez S, Dogan S. Comparative evaluation of nasopharyngeal airways of unilateral cleft lip and palate patients using three-dimensional and two-dimensional methods. Cleft Palate Craniofac J. 2012;49(6):e75-81. [Crossref] [PubMed]
- Celikoglu M, Buyuk SK, Sekerci AE, Ucar FI, Cantekin K. Three-dimensional evaluation of the pharyngeal airway volumes in patients affected by unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop. 2014;145(6):780-6. [Crossref] [PubMed]
- Paknahad M, Pourzal A, Mahjoori-Ghasrodashti M, Khojastepour L. Evaluation of maxillary sinus characteristics in patients with cleft lip and palate using cone beam computed tomography. Cleft Palate Craniofac J. 2022;59(5):589-94. [Crossref] [PubMed]
- Rodrigues ML, Francisco I, Caramelo F, Figueiredo JP, Vale F. A retrospective and tridimensional study of the maxillary sinus in patients with cleft lip and palate. Am J Orthod Dentofacial Orthop. 2021;159(1):e17-e24. [Crossref] [PubMed]
- Najm AA, Hadi FA, Murtadha R. Volumetric assessment of maxillary sinus in cleft lip and palate patients in comparison to normal subjects. Annals of Tropical Medicine and Public Health. 2020;23(12). [Link]
- Salib RJ, Chaudri SA, Rockley TJ. Sinusitis in the hypoplastic maxillary antrum: the crucial role of radiology in diagnosis and management. J Laryngol Otol. 2001;115(8):676-8. [Crossref] [PubMed]
- van der Veken PJ, Clement PA, Buisseret T, Desprechins B, Kaufman L, Derde MP. CT-scan study of the incidence of sinus involvement and nasal anatomic variations in 196 children. Rhinology. 1990;28(3):177-84. [PubMed]
- Jiang M, You M, Wang S, Wang K, Feng B, Wang H. Analysis of nasal septal deviation in cleft palate and/or alveolus patients using cone-beam computed tomography. Otolaryngol Head Neck Surg. 2014;151(2):226-31. [Crossref] [PubMed]
- Kuijpers MAR, Pazera A, Admiraal RJ, Bergé SJ, Vissink A, Pazera P. Incidental findings on cone beam computed tomography scans in cleft lip and palate patients. Clin Oral Investig. 2014;18(4):1237-44. [Crossref] [PubMed]
- Bogoroditskaya AV, Sarafanova ME, Radtsig EY, Prityko AG. [The state of the nasal cavity and paranasal sinuses in the children presenting with congenital cleft of upper lip and palate]. Vestn Otorinolaringol. 2015;80(6):19-21. Russian. [Crossref] [PubMed]
- Dedeoglu N, Altun O, Kucuk EB, Altindis S, Hatunogl E. Evaluation of the anatomical variation in the nasal cavity and paranasal sinuses of patients with cleft lip and palate using cone beam computed tomography. Bratisl Lek Listy. 2016;117(12):691-6. [Crossref] [PubMed]
.: İşlem Listesi