Evaluation of maxillary sinus pathologies in children and adolescents with cleft lip and palate using cone BEAM computed tomography: A retrospective study

The aim of this study is to retrospectively evaluate maxillary sinus pathologies in children and adolescents with cleft lip and palate and compare them with those of a sex- and age-matched control group using Cone-Beam Computed Tomography (CBCT). For the sampling, the CBCT images of 7-18 aged patients between the years 2014 and 2022 were retrieved from the archives of the Department of Oral and Maxillofacial Radiology at Yeditepe University, the Faculty of Dentistry. Four hundred and two scans were reviewed initially. All scans were taken using the same imaging device (i-CAT Imaging Science International, Inc. Hatfield, PA, USA). Based on inclusion and exclusion criteria, groups were designed and matched according to gender and age. Then a total of 130 scans were considered eligible for this study. After evaluating the coronal, sagittal, and axial views of the scans, a yes/no scale was used to determine the presence or absence of sinus pathologies. Findings of the maxillary sinus were categorized into groups based on the level and pattern of sinus opacification. The groups were: (1) healthy, (2) mucosal thickening >3 mm, (3) polypoidal mucosal thickening, (4) partial opacification, and (5) complete opacification. Variations of polypoidal mucosal thickenings were subcategorized as small, large, and multiple. The right and left sinuses of the patients in the CLP and control groups were recorded separately for pathologies. Also, the cleft side of the CLP patients was noted to identify the relationship with the side of the pathology. Among 130 patients, polypoidal mucosal thickening (25.4%) was found as the most frequent sinus pathology, followed by mucosal thickening greater than 3 mm (19.2%), partial opacification (6.1%), and total opacification (1.6%). The comparison of the presence and absence of the pathologies, the comparison of the sides of the pathologies, and the comparison of the groups resulted only in the number of sinuses with mucosal thickening greater than 3 mm was significantly higher in the CLP than that of the control group (p<0.05). Comparing the frequency of pathology based on the sinuses according to cleft types and cleft sides showed no significant difference in any of the pathology groups (p > 0.05). In conclusion, CBCT plays a very important role in detecting incidental findings in the oral and maxillofacial region. For children with CLP, it's absolutely essential to get an early diagnosis of maxillary sinusitis. Keywords: Cleft Lip and Palate, Maxillary Sinus, Pathology, Children, CBCT