Three-dimensional evaluation of maxillary sinus and maxilla for adolescent patients with unilateral cleft lip and palate using cone-beam computed tomography

Background and objective: Maxillary sinus disease is frequently observed in patients with unilateral cleft lip and palate (UCLP). The anatomical variations of maxillary sinus and maxilla may play a role in the high incidence of sinusitis. The aims of this study were to evaluate and compare the three-dimensional (3D) structural features of maxillary sinus and maxilla in UCLP adolescent patients between the defect and non-defect sides, and investigate the morphological relationship between the maxillary sinus and maxilla on the defect side by using cone-beam computed tomography (CBCT). Methods: CBCT images were acquired from 42 UCLP adolescent patients. Maxillary sinus and maxilla on the defect and non-defect sides were segmented respectively and assessed three dimensionally, and the comparison was performed by paired t-test. A multiple linear regression was conducted to investigate the morphological relationship between the maxillary sinus and maxilla on the defect side. Results: No statistically significant difference was observed in any parameter of the maxillary sinus between the defect and non-defect sides (P > 0.05). Significant differences were observed in the length, anterior width, anterior height, and volume of the maxilla between the defect side and non-defect sides (P < 0.05). The parameters of maxillary sinus were significant related to the posterior width and height of maxilla on the defect side. Conclusion: Adolescent patients with UCLP present similar 3D structural features of the maxillary sinus on both sides. Significant differences of the maxilla between the defect and non-defect sides were displayed in the area adjacent to the defect but not showed in the posterior portion of maxilla. Certain structures of the posterior portion of maxilla contribute to the variability of maxillary sinus.