Precise volumetric evaluation of the alveolar cleft facilitates accurate preparation of bone substitutes and reduces donor site morbidity. This study investigates 2 advanced presurgical volumetric assessment methods that use computer-aided engineering (CAE) software. Preoperative computed tomography (CT) scans from 20 unilateral alveolar cleft patients undergoing secondary alveolar bone grafting (SABG) were analyzed by CAE software. Cleft defect volumes were calculated using the mirror-reversed technique and the subtraction method. The mirror-reversed technique determines defect volume by reversing the noncleft side to the cleft side. The subtraction method determines defect volume by subtracting a mask of the preoperative cleft from a mask generated after simulated cleft filling. The mean defect volumes and calculation times of the mirror-reversed technique (1.27 ± 0.35 cm3; 11.80 ± 1.79 seconds) and the subtractive method (1.23 ± 0.32 cm3; 9.43 ± 1.35 seconds) did not differ significantly. In Bland–Altman analysis the 2 methods were equivalent for alveolar cleft defect assessment. Both methods exhibited acceptable interobserver reliability, high precision, clinical convenience, time efficiency, and high reproducibility, and can serve as valuable tools for the planning and execution of SABG. The subtraction method has broader potential applicability and can simulate intraoperative bone grafting more effectively.

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In addition, in this study, only 2 of the 115 infants diagnosed with congenital microtia had a clear family history of microtia. Of the 115 mothers with microtia babies, 13 had used tocolytic agents, 16 had a history of miscarriage, 79 had > 1 pregnancy, and 19 had complications during pregnancy. But there was no evidence that these factors are associated with the incidence of microtia. In terms of educational attainment of mothers of babies with microtia, the proportion of women with a college degree or above accounted for 61.74%, those with high school degree accounted for 21.74%, and those with junior high school degree or below accounted for 16.52%. These results do not mean that women with higher education are more likely to give birth to microtia babies, but rather that compulsory education on the Chinese mainland has led to higher education levels among pregnant women.The study included 14,9525 newborns with 4247 congenital malformations, with a total of 115 infants diagnosed with congenital microtia. The sample size is large and the conclusion is representative. However, there are also limitations in this study. The severity and location of microtia were not distinguished in the statistics of infants with congenital microtia. Therefore, the incidence of microtia in different degrees and ears at different positions could not be counted. The samples used in this study were from the Birth defect monitoring hospital in Shandong Province, mainly including Chinese infants with congenital microtia. Therefore, whether the results can be applied to the incidence of microtia in other countries and ethnic groups remains to be verified. Limited by the data collected, this study only analyzed the relationship between the incidence of congenital microtia and infant sex, maternal age, and maternal residence. The relationship between other factors and the incidence of congenital microtia was not systematically explored. In later studies, we will further explore the internal and external factors that may influence the incidence of congenital microtia.

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