The aim of the present research was to assess and compare the piriform aperture dimensions of subjects with a unilateral cleft lip and palate (UCLP) and those of a control group using cone-beam computed tomography (CBCT).
Design
CBCT data of 40 subjects with a complete UCLP (28 males and 12 females, with a mean age of 17.21 ± 5.75 years) and 40 CBCT images of age- and sex-matched subjects with no cleft, serving as the control group (28 males, 12 females; mean age, 17.25 ± 5.74 years) were included in the study. The maximal height and width of the piriform aperture as well as nasal bone height were measured and statistically compared between the groups.
Results
There were no significant differences in the age and sex distributions between the groups. The mean piriform aperture height was significantly lower in the UCLP group than in the control group, while the mean piriform aperture width was significantly higher in the UCLP group compared to the control group (P < .01). Furthermore, the mean bony nasal height was found to be significantly lower in the UCLP group than in the control group (P < .01).
Conclusions
According to the present findings, UCLP is associated with changes in the piriform aperture dimensions due to lower height and higher width values. These structural alterations may contribute to the functional and aesthetic nasal challenges in patients with UCLP.
SalariNDarvishiNHeydariM, et al.Global prevalence of cleft palate, cleft lip and cleft palate and lip: A comprehensive systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2022;123(2):110-120.
2.
LeslieEJCarlsonJCShafferJR, et al.A multi-ethnic genome-wide association study identifies novel loci for non-syndromic cleft lip with or without cleft palate on 2p24. 2, 17q23 and 19q13. Hum Mol Genet. 2016;25(13):2862-2872.
3.
KohliSSKohliVS. A comprehensive review of the genetic basis of cleft lip and palate. J Oral Maxillofac Pathol. 2012;16(1):64-72.
4.
ErdurOUcarFISekerciAECelikogluMBuyukSK. Maxillary sinus volumes of patients with unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol. 2015;79(10):1741-1744.
5.
HairfieldWMWarrenDWSeatonDL. Prevalence of mouthbreathing in cleft lip and palate. Cleft Palate J. 1988;25(2):135-138.
6.
FukushiroAPKiemle TrindadeEI. Nasal airway dimensions of adults with cleft lip and palate: Differences among cleft types. Cleft Palate Craniofac J. 2005;42(4):396-402.
7.
HitotsumatsuTMatsushimaTRhotonAL. Surgical anatomy of the midface and the midline skull base. Oper Tech Neurosurg. 1999;2(4):160-180.
8.
PapeschEPapeschM. The nasal pyriform aperture and its importance. Otorhinolaryngol Head Neck Surg. 2016;1(4):89-91.
9.
MoredduEPuymerailLMichelJ, et al.Morphometric measurements and sexual dimorphism of the piriform aperture in adults. Surg Radiol Anat. 2013;35(10):917-924.
10.
de AraújoTMSda SilvaCJTde MedeirosLKN, et al.Morphometric analysis of piriform aperture in human skulls. Int J Morphol. 2018;36(2):483-487.
11.
HwangT-SSongJYoonHChoB-PKangH-S. Morphometry of the nasal bones and piriform apertures in Koreans. Ann Anat. 2005;187(4):411-414.
12.
WaingadeMMRathodPMahajanMKhandareN. Forensic importance of piriform aperture: An overview. Indian J Dent Adv. 2019;11(3):108-111.
13.
EslamiNZarchHHJahanbinADarabiZMoayediS. Comparison of nasopharyngeal airway volume in cleft lip and palate patients with normal individuals using cone beam computed tomography. J Craniofac Surg. 2023;34(3):1111-1114.
14.
FaulFErdfelderELangA-GBuchnerA. G* power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods.2007;39(2):175-191.
15.
MeyvaciSSKosifRBamaçBHizalMAnkaraliH. Evaluation of apertura piriformis and related cranial anatomical structures through computed tomography: Golden ratio. Folia Morphol. 2019;78(4):839-846.
16.
ThomasEMGibikoteSPanwarJSMathewJ. Congenital nasal pyriform aperture stenosis: A rare cause of nasal airway obstruction in a neonate. Indian J Radiol Imaging. 2010;20(4):266-268.
PradoFBCaldasRARossiAC, et al.Piriform aperture morphometry and nasal bones morphology in Brazilian population by postero-anterior Caldwell radiographys. Int J Morphol. 2011;29(2):393-398.
19.
BasciftciFMutluNKaramanAMalkocSKüçükkolbasiH. Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions?Angle Orthod. 2002;72(2):118-123.
20.
AbdelaleemSAYounisRHKaderMA. Sex determination from the piriform aperture using multi slice computed tomography: Discriminant function analysis of Egyptian population in Minia Governorate. Egypt J Forensic Sci. 2016;6(4):429-434.
21.
ChungE-JYangB-EParkI-Y, et al.Effectiveness of cone-beam computed tomography-generated cephalograms using artificial intelligence cephalometric analysis. Sci Rep. 2022;12(1):20585.
22.
ScarfeWCFarmanAG. What is cone-beam CT and how does it work?Dent Clin North Am. 2008;52(4):707-730.
23.
KappenIFBittermannGKSchoutenRM, et al.Long-term mid-facial growth of patients with a unilateral complete cleft of lip, alveolus and palate treated by two-stage palatoplasty: Cephalometric analysis. Clin Oral Investig. 2017;21(5):1801-1810.
24.
LambrechtJTKreuschTSchulzL. Position, shape, and dimension of the maxilla in unoperated cleft lip and palate patients: Review of the literature. Clin Anat. 2000;13(2):121-133.
25.
LiuR-KWamalwaPLuD-W, et al.Soft-tissue characteristics of operated unilateral complete cleft lip and palate patients in mixed dentition. J Craniofac Surg. 2011;22(4):1275-1279.
26.
BearnDRSandyJRShawWC. Cephalometric soft tissue profile in unilateral cleft lip and palate patients. Eur J Orthod. 2002;24(3):277-284.
27.
HasanzadehNMajidiMRKianifarHEslamiN. Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate. J Craniofac Surg. 2014;25(1):314-317.
28.
ErtaşÜAtaolM. Evaluation of nasal airway volume of operated unilateral cleft lip and palate patients compared with skeletal class III individuals. Cleft Palate Craniofac J. 2019;56(1):15-20.
29.
VassGMohosGBereZ, et al.Secondary correction of nasal deformities in cleft lip and palate patients: Surgical technique and outcome evaluation. Head Face Med.2016;12(1):1-5.
30.
FriedeHEnemarkH. Long-term evidence for favorable midfacial growth after delayed hard palate repair in UCLP patients. Cleft Palate Craniofac J.2001;38(4):323-329.
31.
LiaoY-FYangI-YWangRYunCHuangC-S. Two-stage palate repair with delayed hard palate closure is related to favorable maxillary growth in unilateral cleft lip and palate. Plast Reconstr Surg.2010;125(5):1503-1510.
32.
BakriSRizellSLiljaJMarkH. Vertical maxillary growth after two different surgical protocols in unilateral cleft lip and palate patients. Cleft Palate Craniofac J.2014;51(6):645-650.
33.
HollandSGabbayJSHellerJB, et al.Delayed closure of the hard palate leads to speech problems and deleterious maxillary growth. Plast Reconstr Surg.2007;119(4):1302-1310.
34.
PradelWSenfDMaiR, et al.One-stage palate repair improves speech outcome and early maxillary growth in patients with cleft lip and palate. J Physiol Pharmacol. 2009;60(Suppl 8):37-41.
35.
MikoyaTShibukawaTSusamiT, et al.Dental arch relationship outcomes in one-and two-stage palatoplasty for Japanese patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J.2015;52(3):277-286.
36.
ZemannWKärcherHDrevenšekMKoželjV. Sagittal maxillary growth in children with unilateral cleft of the lip, alveolus and palate at the age of 10 years: An intercentre comparison. J Cranio-Maxillofacial Surg. 2011;39(7):469-474.
37.
SalgadoKRWendtARFagundesNCF, et al.Early or delayed palatoplasty in complete unilateral cleft lip and palate patients? A systematic review of the effects on maxillary growth. J Cranio-Maxillofacial Surg. 2019;47(11):1690-1698.
