Quantitative analysis of paranasal sinus volumes in cleft lip and palate patients using cone-beam computed tomography

Context: Cleft lip and palate (CLP) is a craniofacial anomaly that may interfere with the growth and development of adjacent structures, including the paranasal sinuses. Aims: This study aimed to evaluate and compare the volumes of the maxillary, frontal, ethmoidal, and sphenoidal sinuses in individuals with unilateral CLP, bilateral CLP, and non-cleft controls using cone-beam computed tomography (CBCT). Settings and Design: Retrospective cross-sectional study. Subjects and Methods: CBCT scans of 300 individuals (mean age: 23.8 ± 4.6 years) were analyzed and divided into three groups: unilateral CLP ( n = 100), bilateral CLP ( n = 100), and noncleft controls ( n = 100). All scans presented an adequate field of view for paranasal sinus evaluation. Volumetric measurements were obtained through semiautomatic segmentation using ITK-SNAP software with multiplanar assessment. Statistical Analysis Used: Data normality was assessed, and parametric or nonparametric statistical tests were applied as appropriate. Statistical significance was established at P < 0.05. Results: Individuals with CLP presented significantly larger frontal sinus volumes compared to controls ( P < 0.001). In unilateral CLP cases, a tendency toward reduced maxillary sinus volume on the cleft side was observed, although without statistical significance ( P = 0.052). No significant differences were found in ethmoidal ( P = 0.472) or sphenoidal sinus volumes ( P = 0.595). Volumetric differences mainly affected the anterior paranasal sinuses. Conclusions: CLP is associated with selective volumetric changes in the paranasal sinuses, characterized by reduced maxillary sinus volume and increased frontal sinus volume. CBCT-based volumetric analysis is a reliable method for detecting craniofacial adaptations and may contribute to surgical planning and individualized rehabilitation in patients with CLP.