Volumetric Assessment of Maxillary Sinus Changes After Le Fort I Osteotomy in Cleft Lip and Palate Patients: A Pilot Study

Abstract

Objective

To assess volumetric and morphological changes in the maxillary sinus of patients with cleft lip and palate (CLP) undergoing Le Fort I osteotomy using cone-beam computed tomography (CBCT) and 3D segmentation.

Design

Retrospective observational pilot study.

Setting

A specialized CLP treatment center in the oral and maxillofacial surgery department.

Patients/Participants

Thirty adults with CLP (15 unilateral, 15 bilateral) who underwent Le Fort I osteotomy, with preoperative and ≥12-month postoperative CBCT scans available.

Methods

Three-dimensional segmentation of the maxillary sinus was performed using ITK-SNAP software on pre- and postoperative CBCT scans to calculate volumetric changes.

Outcome Measure

Maxillary sinus volume (mm³) before and after surgery.

Results

Both groups exhibited postoperative reductions in sinus volume. In the unilateral group, mean bilateral volume decreased from 12 272 mm³ to 11 433 mm³; in the bilateral group, from 15 082 mm³ to 14 519 mm³. Although the unilateral group showed slightly greater reduction, differences were not statistically significant within or between groups (P > 0.05).

Conclusions

Le Fort I osteotomy led to modest postoperative volumetric reduction in the maxillary sinus in both unilateral and bilateral CLP patients. Bilateral CLP cases consistently exhibited larger sinus volumes pre- and postoperatively compared to unilateral cases. These findings suggest cleft morphology influences sinus anatomy and that surgical intervention may alter its structure. Although volumetric changes were not significant, frequent morphological variations highlight the need for ongoing postoperative radiological monitoring.