Volumetric Analysis of the Maxillary Sinus in Patients with Cleft Lip and Palate Before and After Orthognathic Surgery

Abstract

Objective

To evaluate maxillary sinus volumetric changes in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) undergoing Le Fort I osteotomy.

Design

Retrospective observational study.

Setting

Single tertiary craniofacial rehabilitation center.

Participants

A total of 200 patients aged 18 years or older were included, comprising 100 individuals with UCLP and 100 with BCLP, all presenting preoperative and 1-year postoperative cone-beam computed tomography scans.

Interventions

All participants underwent Le Fort I osteotomy as part of orthognathic surgical treatment.

Main Outcome Measures

Volumetric segmentation of the maxillary sinuses and sinus lesions was performed using ITK-SNAP software. Volumes were measured in cubic millimeters using preoperative and 1-year postoperative cone-beam computed tomography scans.

Results

In UCLP patients, no significant differences were observed in total maxillary sinus volume between preoperative and postoperative periods, although lesion volume was significantly reduced. In BCLP patients, a significant postoperative increase in sinus volume was observed, accompanied by a reduction in lesion volume. In both groups, the cleft side consistently presented smaller sinus volumes.

Conclusions

Maxillary sinus volume remains smaller on the cleft side regardless of surgical intervention. Le Fort I osteotomy does not significantly affect sinus volume in UCLP patients, whereas BCLP patients demonstrate a postoperative volumetric increase.