Three-dimensional Evaluation Of Nasopharyngeal Airway In Cleft Lip And Palate Individuals After Surgically Assisted Rapid Palatal Expansion Using CBCT

Objective:To evaluate the nasopharyngeal airway dimensions among growing unilateral cleft lip and palate patients and normally growing individuals,and analyze the changes caused by surgically assisted rapid palatal expansion in cleft individuduals.Methods:The study sampleconsisted of 22 individuals(20boys,2girls),divided into 2 groups:unilateral cleft lip and palate(10boys,2girls)and skeletal class I(control group;10boys),treating in the orthodontic office on the first affiliated hospital to Fu Jian medical university from June,2014 to Octobor,2016.Every patien was in the early stage or peak period of growth.8 patients from UCLP groupwere treated withsurgically assisted rapid palatal expansion.Cone-beam computed tomography images were taken before and 3 months after expansion.All CBCT images of every patient were collected and retained by DICOM.The volume,cross-section area,length and width of nasal,nasopharyngeal and orthopharyngeal airway dimensions were measured by Minmics19.0 software.Nasalcavity width,maxillary width,archwidth,palatal cleft widthwere assessed by EZ3D2009 software.All samples were measured by the same investigator,and remeasured again after two weeks.Using Intraclass correlation test(ICC)to evaluate the consistency(95% confident interval)of checker itself of all variables by two measure date,eventually take two measurement as the purpose of this study to measure the average value.Interphase and intergroup comparisons wereperformed using paired t tests and t tests,respectively(p < 0.05).? Using two independent samples t testto compare the difference of airway between Skeletal I group and unilateral cleft lip and palate group,and using the paired samples t test to compare airway change differencebefore and after surgery assisted rapid expansion,in SPSSl7.O statistical data packets.To analyze relationship among the airway,the the upper and lower jaw bone and the soft palate groups using Pearson coefficient.Results: Patients affected by unilateral cleft lip and palate has smaller nasal airway volume compared control group,the difference was statistically siginificant(p<0.05),but no siginificant difference on pharyngeal airway.The differeneces of cross-section area,the maximal length and width of different airway dimensions between UCLP group and control group were not significant(p>0.05).The length of velum was small and the angel of velum was large in unilateral cleft lip and palte group than control group,only siginificant(p<0.05)in the velum angular.The dimension of nasal airway has a positive correlation with the sagittal dimension of maxillary,maxillary width,nasal width and the length of maxillary.Negative correlation was exsit between the volumn of velopharyngeal airway and the angle of the velum,the volumn of glossopharyngeal and the angle of ANB.Surgically assisted rapid maxillaryexpansion led to a statistically significant increase(P<0.05)in nasal airway volume,nasalcavity width,maxillary width,archwidth,palatal cleft widthin the group as a whole.Conclusion:Thejuvenilepatients affected by unilateral cleft lip and palate had decrease nasal airway volume(p<0.05)compared with no clefts,effecting by transvers and sagittal development of maxillary,but no differ siginifiance on phrayngeal airway.Surgically assisted rapid palatal expansion can produce siginificant nasal airway volume.