Three-Dimensional Evaluation of Pharynx in Patients With Different Severity Levels of Cleft Palate Using Cone-Beam Computed Tomography

This study was performed to investigate the pharynx in patients with varying severities of cleft palate. Cone-beam computed tomography (CBCT) data of 60 nonsyndromic patients with hard and soft palate cleft (HSCP), submucous cleft palate (SMCP), or congenital velopharyngeal incompetence (CVPI), and 20 age-matched healthy controls were retrospectively collected. Image processing and pharyngeal analyses were conducted using Mimics and ZWCAD software. All statistical analyses were performed using SPSS software, and the threshold of significance was set at P =0.05. Results showed that bony nasopharyngeal measurements of all patient groups were larger than normal ( P <0.05). Among all patient groups, HSCP patients demonstrated the largest bony nasopharynx ( P <0.05). Relative to controls, HSCP patients showed greater bony pharyngeal depths ( P <0.05), while no significant difference was observed in CVPI patients ( P >0.05). Among all patient groups, HSCP patients had the largest bony pharyngeal depths ( P <0.05). Airway pharyngeal analysis indicated that all patients displayed significantly increased measurements at the palatal plane ( P <0.05), with HSCP patients showing the most pronounced increments ( P <0.05). Of the 20 pharyngeal measurements, only the bony pharyngeal depth at the palatal plane differed between SMCP and CVPI patients ( P <0.05). Collectively, all patients exhibited sagittal enlargement of the bony nasopharynx and dilation of pharyngeal airway at the palatal plane, with pharyngeal deviations positively correlated with cleft severity. The presence of an overt palatal cleft was identified as the primary determinant of the severity of pharyngeal structural alterations.