Adults With Unilateral Cleft Lip and Palate Present Reduced Internal Nasal Volumes: Findings of a Three-Dimensional Morphometric Assessment in Cone-Beam Computed Tomography Scans

Inocentes, R. J. M.; Marzano‐Rodrigues, Maria Noel; Espíndola, Guilherme Gonçalves de; Garcia-Usó, Michele; Yatabe-Ioshida, Marilia Sayako; Trindade, Inge Elly Kiemle; Trindade‐Suedam, Ivy Kiemle

doi:10.1097/scs.0000000000006820

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…The results of this study elucidate the sites of greatest reductions in the airways of individuals with TCS, for a better characterization of the predisposing factors for OSA. Considering that patients with craniofacial anomalies often present a reduced UA [ 3 , 16 , 34 , 35 , 36 , 37 , 38 ], it is expected a reduced and/or obstruction of the airflow, especially during sleep, when the pharyngeal muscle tone is reduced [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals

dos Inocentes,

de Almeida Ribeiro,

Marzano-Rodrigues

et al. 2024

International Journal of Dentistry

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Purpose. Sleep apnea symptoms, such as snoring and daytime somnolence, are commonly observed in individuals with Treacher Collins Syndrome (TCS) and may be related to airway obstruction due to micro‐ and retro‐gnathia. This study aims to three‐dimensionally evaluate the upper airway using cone‐beam computed tomography (CBCT) exams of adolescents (TCS‐ADOL) and adults (TCS‐ADUL) with TCS compared to a nonsyndromic group (CON). Materials and Methods. Twenty‐six CBCT exams were divided into three groups: TCS‐ADOL (n = 7) (13.14 ± 1.67 years): CBCT exams of TCS adolescents; TCS‐ADUL (n = 10) (21.80 ± 4.39 years): CBCT exams of TCS adults; and CON (n = 9) (25.33 ± 8.57 years): CBCT exams of adult nonsyndromic individuals with Class II skeletal pattern. The variables analyzed were (1) total upper airway volume; (2) nasal cavity volume; (3) total pharyngeal volume; (4) nasopharyngeal volume; (5) oropharyngeal volume; (6) pharyngeal minimal cross‐sectional area; (7) pharyngeal length; and (8) pharyngeal depth. Scans were analyzed by two examiners, and intra‐ and inter‐rater agreement was calculated. A p‐value of ≤0.05 was considered significant. Results. Although not statistically significant, the TCS‐ADUL group showed decreased airway volume and minimal cross‐sectional areas compared to the CON group. There were also significant differences between TCS‐ADOL and TCS‐ADUL, with significantly lower airway volumes in the TCS‐ADOL group. Strong positive correlations were found between certain airway measurements in the TCS‐ADOL group, which were not observed in adults. Conclusions. The upper airways of adults with TCS are dimensionally similar to those of nonsyndromic individuals, despite absolute value reductions found in the syndromic group. The reduced airway in the adolescent population suggests significant potential for growth, mainly in pharyngeal dimensions.

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Section: Discussionmentioning

confidence: 99%

Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals

dos Inocentes,

de Almeida Ribeiro,

Marzano-Rodrigues

et al. 2024

International Journal of Dentistry

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“…CBCT is a well-recognized method to evaluate the morphology and internal geometry of the UA in different groups of patients, 20,34,35 such as rhinomanometry and acoustic rhinometry. 26,28 Thus, studies evaluating the nasal and UA morphology of patients with OSA and CL/P, by tomographic analysis, can contribute to a better understanding of the role of nasal cavity dimensions in the occurrence of OSA.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Internal Nasal Dimensions of Individuals With Cleft Lip and Palate and Obstructive Sleep Apnea Syndrome by Computed Tomography

Loureiro

Marzano‐Rodrigues

Trindade‐Suedam

et al. 2022

The Cleft Palate Craniofacial Journal

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To evaluate nasal cavity (NC) dimensions of individuals with cleft lip and/or palate (CL/P), obstructive sleep apnea (OSA), and primary snoring, by tomographic image analysis, compared to individuals with OSA without CL/P (N-CL/P). Cross-sectional and retrospective. Tertiary referral center. Patients were divided into 2 groups: (G1) CL/P + OSA or primary snoring, n = 11; (G2) N-CL/P + OSA, n = 13. NC tomographic images were reconstructed using ITK-SNAP software, and measurements were obtained from these three-dimensional models using SpaceClaim software. Total NC volumes, right and left NC volumes, and volumes of the nostril to the nasal valve (V1) and from the nasal valve to the superior limit of the nasopharynx (V2), cross-sectional areas, and perimeters. NC volumes (total, right, and left sides), V1, and V2, though smaller in the CL/P + OSA, did not differ significantly from the N-CL/P + OSA. Cross-sectional areas and perimeters of the superior limit of the nasopharynx, in the CL/P + OSA, presented significantly higher values compared to the N-CL/P + OSA ( P ≤ .05). The internal nasal dimensions of patients with CL/P do not seem to be part of the etiopathogenesis, nor constitute a risk factor for OSA with greater severity, in this special group of patients.

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Impact of Unilateral Alveolar Bone Grafting on Nasal Volume and Nasolabial Surface: A 3D Analysis

Sijmons,

Krijt,

Bruggink

et al. 2023

The Cleft Palate Craniofacial Journal

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Objective To determine possible effects of unilateral alveolar cleft closure on internal nasal volume and external nasolabial surface. Design Retrospective, single-arm, cohort study. Setting Institutional, tertiary care. Patients Patients with complete unilateral cleft lip, alveolus, and palate (CUCLAP), who underwent closure of the alveolar cleft with autologous bone graft (ABG) at the age of 9–11 years, with cone beam computed tomography (CBCT) and/or three-dimensional (3D) stereophotogrammetry images taken before and one year after the ABG procedure. Interventions ABG-pocedure in patients with CUCLAP. Main Outcome Measures The influence of ABG on the internal and external nasal morphology. Results A total of 28 patients (21M/7F, 14R/14L) were divided into internal (CBCT) and external (3D-stereophotogrammetry) measurement subgroups. The external nasolabial surface showed a significant decrease of the angle alar curvature right–subnasale–alar curvature left (−1.99°; P = .02; 95% CI −2.61, −0.36) and an increase of the linear measurement between these points (+1.01 mm; P = .03; 95% CI: 0.11, 1.91). No significant differences were found when comparing the distance maps of the affected side with the non-affected side ( P = .50, 95% CI: −0.20, 0.29). Conclusions Closure of the alveolar cleft in CUCLAP patients with ABG did not affect the internal nasal volume, but significantly affected the external nasal surface. The procedure resulted in the nose becoming wider because both alar curvatures moved caudally and laterally relative to the subnasale.

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Adults With Unilateral Cleft Lip and Palate Present Reduced Internal Nasal Volumes: Findings of a Three-Dimensional Morphometric Assessment in Cone-Beam Computed Tomography Scans

Cited by 3 publications

References 29 publications

Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals

Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals

Assessment of Internal Nasal Dimensions of Individuals With Cleft Lip and Palate and Obstructive Sleep Apnea Syndrome by Computed Tomography

Impact of Unilateral Alveolar Bone Grafting on Nasal Volume and Nasolabial Surface: A 3D Analysis

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