Öz
Amaç
Dudak ve damak yarığı (DDY), kraniyofasiyal bölgede en sık görülen konjenital anomalilerden biridir. DDY’li hastalarda orta yüzü ilgilendiren birçok malformasyon ortaya çıkabilir. Bu çalışmada, yarıkların maksiller sinüs patolojisi (MSP), konka bülloza ve ostium tıkanıklığı üzerine etkisinin konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak değerlendirilmesi amaçlandı.
Yöntemler
Bu retrospektif çalışmaya 30’u unilateral DDY (UDDY), 30’u bilateral DDY ve 30’u kontrol olmak üzere toplam 90 hasta dahil edildi. Yarık varlığının MSP, konka bülloza ve ostium tıkanıklığına etkisi KIBT görüntüleri kullanılarak belirlendi.
Bulgular
Çalışma popülasyonunun toplam 180 sağ ve sol tarafı 90 yarık ve 90 normal taraf olmak üzere iki gruba ayrıldı. UDDY hastalarında yarık varlığı ile incelenen parametreler arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Tüm hastalarda yarık varlığında MSP (%83,3, p<0,001) ve ostium tıkanıklığı (%17,8, p=0,011) görülme sıklığı istatistiksel olarak anlamlıydı. Ancak yarık varlığının konka bülloza üzerinde istatistiksel olarak anlamlı bir etkisi olmadı. Yarık varlığı MSP’yi 4,2 kat, ostium tıkanıklığını ise 3,7 kat artırdı.
Sonuç
Yarık varlığı MSP ve ostium tıkanıklığı riskini artırırken konka bülloza varlığı ile ilişkili değildi.
Anahtar Kelimeler: Dudak ve damak yarığı, konka bülloza, konik ışınlı bilgisayarlı tomografi, maksiller sinüs, ostium
Kaynakça
Celikoglu M, Halicioglu K, Buyuk SK, Sekerci AE, Ucar FI. Condylar and ramal vertical asymmetry in adolescent patients with cleft lip and palate evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2013;144:691-7.
Shapira Y, Lubit E, Kuftinec MM, Borell G. The distribution of clefts of the primary and secondary palates by sex, type, and location. Angle Orthod. 1999;69:523-8.
Lawson W, Patel ZM, Lin FY. The development and pathologic processes that influence maxillary sinus pneumatization. Anat Rec (Hoboken). 2008;291:1554-63.
Lund VJ, Kennedy DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg. 1997;117:35-40.
Kyrkanides S, Bellohusen R, Subtelny JD. Skeletal asymmetries of the nasomaxillary complex in noncleft and postsurgical unilateral cleft lip and palate individuals. Cleft Palate Craniofac J. 1995;32:428-33.
Suri S, Utreja A, Khandelwal N, Mago SK. Craniofacial computerized tomography analysis of the midface of patients with repaired complete unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop. 2008;134:418-29.
Agarwal R. Anthropometric evaluation of complete unilateral cleft lip nose with cone beam CT in early childhood. J Plast Reconstr Aesthet Surg. 2011;64:181-2.
Suzuki H, Yamaguchi T, Furukawa M. Rhinologic computed tomographic evaluation in patients with cleft lip and palate. Arch Otolaryngol Head Neck Surg. 1999;125:1000-4.
Ishikawa Y, Kawano M, Honjo I, Amitani R. The cause of nasal sinusitis in patients with cleft palate. Arch Otolaryngol Head Neck Surg. 1989;115:442-6.
Turvey TA, Hall DJ, Warren DW. Alterations in nasal airway resistance following superior repositioning of the maxilla. Am J Orthod. 1984;85:109-14.
Citron I, Lee C, Calabrese CE, Padwa BL. Schneiderian membrane thickness is increased in patients with cleft lip and palate. Cleft Palate Craniofac J. 2020;57:296-301.
Kula K, Hale LN, Ghoneima A, Tholpady S, Starbuck JM. Cone-Beam computed tomography analysis of mucosal thickening in unilateral cleft lip and palate maxillary sinuses. Cleft Palate Craniofac J. 2016;53:640-8.
Paknahad M, Pourzal A, Mahjoori-Ghasrodashti M, Khojastepour L. Evaluation of maxillary sinus characteristics in patients with cleft lip and palate using cone beam computed tomography. Cleft Palate Craniofac J. 2022;59:589-94.
Dedeoglu N, Altun O, Kucuk EB, Altindis S, Hatunogl E. Evaluation of the anatomical variation in the nasal cavity and paranasal sinuses of patients with cleft lip and palate using cone beam computed tomography. Bratisl Lek Listy. 2016;117:691-6.
Göksel S, Özcan İ. A CBCT study for anatomic variations of osteomeatal complex in patients with cleft lip and palate. Cleft Palate Craniofac J. 2023;60:13-20.
Shanbhag S, Karnik P, Shirke P, Shanbhag V. Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study. J Endod. 2013;39:853-7.
Maestre-Ferrín L, Galán-Gil S, Carrillo-García C, Peñarrocha-Diago M. Radiographic findings in the maxillary sinus: comparison of panoramic radiography with computed tomography. Int J Oral Maxillofac Implants. 2011;26:341-6.
Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod. 2012;38:1069-74.
Holberg C, Steinhäuser S, Geis P, Rudzki-Janson I. Cone-beam computed tomography in orthodontics: benefits and limitations. J Orofac Orthop. 2005;66:434-44.
Aps JK. Cone beam computed tomography in paediatric dentistry: overview of recent literature. Eur Arch Paediatr Dent. 2013;14:131-40.
İlgüy M, Dölekoğlu S, Fişekçioğlu E, Ersan N, İlgüy D. Evaluation of pneumatization in the articular eminence and roof of the glenoid fossa with cone-beam computed tomography. Balkan Med J. 2015;32:64-8.
Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:106-14.
Cagici CA, Yilmazer C, Hurcan C, Ozer C, Ozer F. Appropriate interslice gap for screening coronal paranasal sinus tomography for mucosal thickening. Eur Arch Otorhinolaryngol. 2009;266:519-25.
Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:80-7.
Tassoker M. What are the risk factors for maxillary sinus pathologies? A CBCT study. Oral Radiol. 2020;36:80-4.
Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: A retrospective radiologic study. Auris Nasus Larynx. 2017;44:561-70.
Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent. 2010;2010:404982.
Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56-64.
Zinreich SJ, Mattox DE, Kennedy DW, Chisholm HL, Diffley DM, Rosenbaum AE. Concha bullosa: CT evaluation. J Comput Assist Tomogr. 1988;12:778-84.
Kato S, Omori Y, Kanayama M, Hirota A, Ferri M, Apaza Alccayhuaman KA, et al. Sinus mucosa thickness changes and ostium involvement after maxillary sinus floor elevation in sinus with septa. A Cone Beam Computed Tomography Study. Dent J (Basel). 2021;9:82.
