Nasal septal deviation in the unilateral cleft lip and palate deformities: a three-dimensional analysis
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ORIGINAL ARTICLE
Nasal septal deviation in the unilateral cleft lip and palate deformities: a three‑dimensional analysis Gülsün Akay1 · İlkay Eren2 · Özge Karadag3 · Kahraman Güngör1 Received: 26 June 2020 / Accepted: 29 October 2020 © Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2020
Abstract Objectives Lip and palate deformities are an important craniofacial congenital anomaly that negatively affects the anatomy of the nasal cavity and maxilla. This study aimed to evaluate the nasal septum deviation in individuals with a unilateral cleft lip and palate. Methods The sample consists of 22 unilateral cleft lip–palate patients and 20 controls with non-cleft skeletal Class III. Maximal septal deviation angle and linear dimension were measured on cone-beam computed tomography images. The localization of maximal septal deviation was determined. The data were analyzed and compared between unilateral cleft lip–palate patients and skeletal Class III individuals. Results For septal deviation, a significant discrepancy between unilateral cleft patients and skeletal Class III subjects was detected at the anterior nasal spine (ANS) level, the posterior nasal spine (PNS) level and the ANS–PNS midpoint level (p 0.05). The comparison between unilateral CLP patients and control group is summarized in Table 3. The intra-observer reliability was assessed by using ICC and the values ranged between 0.844 and 0.992.
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Oral Radiology
Table 1 Comparison of measurements between patients with unilateral CLP and noncleft patients with Class III
Variables
Septal deviation ANS PNS ANS–PNS midpoint Maximum nasal septal deviation angle ANS–PNS distance (length of the hard palate)
Patients with unilateral CLP (Mean ± SD)
Non-cleft patients with Class III (Mean ± SD)
p value
5.93 ± 1.09 6.70 ± 2.73 7.11 ± 2.82 9.13 ± 2.95 42.11 ± 6.73
3.30 ± 2.59 3.27 ± 2.36 4.96 ± 2.06 7.21 ± 3.46 49.26 ± 3.78
0.001* 0.000* 0.013* 0.039* 0.000*
CLP cleft lip and palate, ANS anterior nasal spine, PNS posterior nasal spine *p value significant at 0.05
Table 2 Comparison of measurements between genders in the unilateral CLP patients and non-cleft patients with Class III
Variables
Unilateral CLP patients (Mean ± SD) Female
Septal deviation ANS 5.88 ± 1.30 PNS 6.81 ± 2.19 ANS–PNS 7.92 ± 2.58 42.70 ± 3.78 ANS–PNS (length of the hard palate) 9.29 ± 2.45 Maximum septal deviation angle
p value
Male
Non-cleft patients with Class III p value (Mean ± SD) Female
Male
5.98 ± 0.89 6.60 ± 3.29 6.29 ± 2.92 41.53 ± 8.98
0.668 0.450 0.200 0.940
3.61 ± 2.75 3.37 ± 1.99 4.73 ± 1.98 48.23 ± 3.68
2.92 ± 2.49 3.16 ± 2.88 5.24 ± 2.24 50.51 ± 3.73
0.619 0.701 0.648 0.160
8.96 ± 3.50
0.554
6.77 ± 2.90
7.82 ± 4.25
0.741
CLP cleft lip and palate, ANS anterior nasal spine, PNS posterior nasal spine
Discussion
Table 3 Localization of the maximal septal deviation Variable
Unilateral CLP patients N; %
Position with turbinate Inferior-turbinate 6; 27.3% Inter-turbinate 8; 36.4% Middle turbina
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