Nasal Septum Morphology in Unilateral and Bilateral Cleft Lip and Palate Determined by 3D Cephalometry

Abstract

: We examined vomer morphology using 3-dimensional 3D analysis and investigated the in uence of the surrounding sutures clefts and maxilla on nasal septum vomer morphology. We evaluated 60 patients who visited our institution. Patients underwent lateral cephalometry and cone-beam computed tomography CBCT upon initial examination. Patients with no signi cant differences in cranial growth were selected and divided into 3 groups of 20 : the bilateral cleft lip and palate BCLP , unilateral cleft lip and palate UCLP , and non-cleft Control groups. We investigated vomer and facial morphologies by using 2-dimensional 2D cephalometry and we also determined vomer morphology by using 3D cephalometry. Results were analyzed using Bonferroni multiple comparison, logistic regression analysis, and factor analysis. Vomer morphology was signi cantly different between the 3 groups. Sagitally, the vomer shape was a narrow quadrilateral that tapered at one end in the BCLP group, trapezoidal in the Control group, and intermediate, like a parallelogram, in the UCLP group. The vomer width was signi cantly greater in the BCLP group. P 0.05 . A signi cant difference was only found in the posterior vomer width between the UCLP and Control groups. The vomer volume was signi cantly larger in the BCLP group. The volume in the UCLP group was larger than in the Control group, but this was not signi cant. Factor analysis revealed that vomer morphology could be clearly distinguished between the 3 groups. Cleft-associated differences in the vicinity of the vomermaxilla palatine bone fusion may in uence vomer formation and may cause the differences observed in vomer morphology between the 3 groups. This suggests that cleft and maxillary morphologies may affect nasal septum morphology.