Citation Information :
Agarwal A. Assessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed Tomography. Int J Clin Pediatr Dent 2016; 9 (1):5-9.
Objective: The aim of our study is to use cone beam computed tomography (CBCT) to assess the dimensional changes in the nasopharyngeal soft-tissue characteristics in children of Indian origin with repaired cleft lip and palate (CLP) and to compare the results with patients with ideal occlusion.
Materials and methods: A sample of 20 children (10 girls, 10 boys) with repaired CLP was selected. Cone beam computed tomography scans were taken to measure the nasopharyngeal airway changes in terms of linear measurements and sagittal cross-sectional areas. Error analysis was performed to prevent systematic or random errors. Independent means t-tests and Pearson correlation analysis were used to evaluate sex differences and the correlations among the variables.
Results: Nasopharyngeal soft-tissue characteristics were different in the control and the study groups. Subjects with repaired CLP had lesser lower aerial width, lower adenoidal width and lower airway width. The upper airway width was also significantly lesser. The retropalatal and the total airway area were significantly greater in the control group.
Conclusion: The narrow pharyngeal airway in patients with CLP might result in functional impairment of breathing in patients. Further investigations are necessary to clarify the relationship between pharyngeal structure and airway function in patients with CLP.
How to cite this article: Agarwal A, Marwah N. Assessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed Tomography. Int J Clin Pediatr Dent 2016;9(1):5-9.
Kirjavainen M, Kirjavainen T. Upper airway dimensions in class II malocclusion. Effects of headgear treatment. Angle Orthod 2007 Nov;77(6):1046-1053.
MacLean JE, Hayward P, Fitzgerald DA, Waters K. Cleft lip and/or palate and breathing during sleep. Sleep Med Rev 2009 Oct;13(5):345-354.
Imamura N, Ono T, Hiyama S, Ishiwata Y, Kuroda T. Comparison of the sizes of adenoidal tissues and upper airways of subjects with and without cleft lip and palate. Am J Orthod Dentofacial Orthop 2002 Aug;122(2):189-194.
Warren DW, Hairfield WM, Dalston ET, Sidman JD, Pillsbury HC. Effects of cleft lip and palate on the nasal airway in children. Arch Otolaryngol Head Neck Surg 1988 Sep;114(9):987-992.
Hairfield WM, Warren DW, Seaton DL. Prevalence of mouthbreathing in cleft lip and palate. Cleft Palate J 1988 Apr;25(2): 135-138.
Drake AF, Davis JU, Warren DW. Nasal airway size in cleft and noncleft children. Laryngoscope 1993 Aug;103(8):915-917.
Rose E, Staats R, Thissen U, Otten JE, Schmelzeisen R, Jonas I. Sleep-related obstructive disordered breathing in cleft palate patients after palatoplasty. Plast Reconstr Surg 2002 Aug; 110(2):392-396.
Marcus CL. Clinical and pathophysiological aspects of obstructive sleep apnea in children. Pediatr Pulmonol Suppl 1997;16:123-124.
Oosterkamp BCM, Remmelink HJ, Pruim GJ, Hoekema A, Dijkstra PU. Craniofacial, craniocervical, and pharyngeal morphology in bilateral cleft lip and palate and obstructive sleep apnea patients. Cleft Palate Craniofac J 2007 Jan;44(1):1-7.
Martin O, Muelas L, Vinas MJ. Nasopharyngeal cephalometric study of ideal occlusions. Am J Orthod Dentofacial Orthop 2006 Oct;130(4):436.e1-436.e9.
Baumrind S, Frantz RC. The reliability of head film measurements. 2. Conventional angular and linear measures. Am J Orthod 1971 Nov;60(5):505-517.
Huang J, Bumann A, Mah J. Three-dimensional radiographic analysis in orthodontics. J Clin Orthod 2005 Jul;39(7):421-428.
Mah J, Hatcher D. Three-dimensional craniofacial imaging. Am J Orthod Dentofacial Orthop 2004 Sep;126(3):308-309.
Maki K, Inou N, Takanishi A, Miller AJ. Modeling of structure, quality, and function in the orthodontic patient. Orthod Craniofac Res 2003;6(Suppl 1):52-58.
Araki K, Maki K, Seki K, Sakamaki K, Harata Y, Sakaino R, Okano T, Seo K. Characteristics of a newly developed dentomaxillofacial x-ray cone beam CT scanner (CB MercuRay): system configuration and physical properties. Dentomaxillofac Radiol 2004 Jan;33(1):51-59.
Cevidanes LH, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop 2006 May;129(5):611-618.
Cevidanes LH, Bailey LJ, Tucker SF, Styner MA, Mol A, Phillips CL, Proffit WR, Turvey T. Three-dimensional conebeam computed tomography for assessment of mandibular changes after orthognathic surgery. Am J Orthod Dentofacial Orthop 2007 Jan;131(1):44-50.
Ogawa T, Enciso R, Memon A, Mah JK, Clark GT. Evaluation of 3D airway imaging of obstructive sleep apnea with conebeam computed tomography. Stud Health Technol Inform 2005;111:365-368.
Ogawa T, Enciso R, Shintaku WH, Clark GT. Evaluation of cross-section airway configuration of obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007 Jan;103(1):102-108.
Dahlberg G. Statistical methods for medical and biological students. New York: Interscience Publications; 1940.
Aboudara CA, Hatcher D, Nielsen IL, Miller A. A threedimensional evaluation of the upper airway in adolescents. Orthod Craniofac Res 2003;6(Suppl 1):173-175.
Jena AK, Singh SP, Utreja AK. Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage. Angle Orthod 2010 Nov;80(6):1061-1067.
Muto T, Yamazaki A, Takeda S. A cephalometric evaluation of the pharyngeal airway space in patients with mandibular retrognathia and prognathia, and normal subjects. Int J Oral Maxillofac Surg 2008 Mar;37(3):228-231.
Tsai HH. Developmental changes of pharyngeal airway structures from young to adult persons. J Clin Pediatr Dent 2007 Spring;31(3):219-221.
Valiathan M, El H, Hans MG, Palomo MJ. Effects of extraction versus non-extraction treatment on oropharyngeal airway volume. Angle Orthod 2010 Nov;80(6):1068-1074.
Hermann NV, Kreiborg S, Darvann TA, Jensen BL, Dahl E, Bolund S. Early craniofacial morphology and growth in children with unoperated isolated cleft palate. Cleft Palate Craniofac J 2002 Nov;39(6):604-622.
Liao YF, Mars M. Long-term effects of lip repair on dentofacial morphology in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J 2005 Sep;42(5):526-532.