Journal of Radiology
Open Access

Abstract

The identification and correction of deformity of maxilla in cleft lip is important to achieve symmetrical results of surgical correction of this deformity. The conventional methods of evaluating the maxilla by clinical anthropometry, cephalometry or dental models do not provide a three dimensional representation of the deformity. The purpose of this study is to document the bony deformity in the maxilla in unilateral cleft lip and palate by three dimensional computed tomography (3D CT) and to estimate the location and degree of maxillary deficiency by volumetric and dimensional measurements to quantify the precise extent of the maxillary deformity. A set of 15 patients (9 males and 6 females) with unilateral secondary cleft lip nose deformity were studied for evaluation and comparison of the maxilla on the cleft and noncleft sides. A set of six parameters have been used for three dimensional evaluation of the maxillary morphology and the measurements of the noncleft side have been compared with an equal number of age and sex matched healthy controls. Comparisons were done using nonparametric statistical analyses. There has been an overall difference in the measurements between the cleft and non-cleft sides. Significant P values (>0.001) for Wilcoxon signed rank test have been obtained for all the measurements. The cleft side has understandably shown reduced values of maxillary length, height, depth and volume. The mean SD values for maxilla have been as follows: length on cleft side (39.52); non-cleft side (42.09), width at canine (34.43); upper second molar (59.57), height of maxilla on cleft side (22.05); non- cleft side (25.43), depth of maxilla on cleft side (31.83); non-cleft side (33.99) and depth of cleft (27.64). All the measurements are in millimeters. The SD values for maxillary volume on the cleft and non-cleft sides have been 11.88 cc and 13.63 cc respectively. The values on the non-cleft side were compared to age and sex matched normal individuals and showed no statistically significant differences. The unilateral cleft lip nose deformity is associated with a characteristic and definite deformity of the maxilla and related bones. Satisfactory correction of cleft lip nose deformity should hence envisage an operative approach which also includes specific corrective procedures for augmenting and correcting the bony deformity.

Biography

Rajiv Agarwal completed MBBS from K.G Medical College in 1989 with certificate of honours in 6 subjects. He was awarded ?College Blue? for the best all round performance in studies and sports. He topped in the postgraduate entrance examination for MS general surgery at the state level. His thesis in both MS and MCh examinations was awarded the best thesis award.