Three-Dimensional Analysis of Nasal Septal Deviation and Maxillary Asymmetry in Unilateral Cleft Lip and Palate Versus Cleft Lip–Alveolus

ObjectiveTo perform a 3-dimensional computed tomography-based comparison of nasal septal deviation and surrounding maxillary structures in patients with unilateral cleft lip and palate (UCLP) and unilateral cleft lip and alveolus (UCLA) during the pre-alveolar bone grafting stage.DesignRetrospective observational study.SettingSingle tertiary care center.Patients, ParticipantsFifty-two consecutive patients in the pre-alveolar bone grafting stage were included (26 with UCLP and 26 with UCLA; age, 6-9 years).InterventionsNone.Main Outcome Measure(s)Nasal septal deviation in anterior, middle, and posterior regions and at superior, middle, and inferior levels within the middle region (MR); deviation of the anterior and posterior nasal spines (PNSs); and maxillary central incisor inclination.ResultsPatients with UCLP showed significantly greater septal deviation toward the cleft side than patients with UCLA, particularly in the MR. Vertical analysis showed the greatest deviation at the middle nasal point in both groups, with larger magnitudes in UCLP. The anterior nasal spine deviated toward the cleft side in both groups, whereas PNS deviation was predominantly observed in UCLP. Cleft-side maxillary central incisor inclination was greater in UCLP than in UCLA. Septal deviation was not significantly correlated with skeletal or dental variables. In contrast, septal length was strongly positively correlated with nasal cavity height in both groups.ConclusionsCleft type is associated with distinct 3-dimensional nasomaxillary morphology, and posterior skeletal asymmetry was characteristic of UCLP. Three-dimensional evaluation by cleft type may aid diagnosis and treatment planning during growth.