Retrospective evaluation of the anatomical variations of the osteomeatalcomplex using cone beam computed tomography by comparing the cleft lip palatepatients and the healthy population

Osteomeatal complex is a key area for the drainage and ventilation of the paranasal sinuses. The obstruction resulting from inflammation and anatomical variations in this region prevents the drainage and ventilation of the sinuses and provides an ideal basis for sinonasal infections. Although cleft lip and palate (CLP) deformities is one of the most common congenital malformations, there is not any previous record in the literature to evaluate the anatomy and variations of OMC in CLP patients. This thesis is the first study to evaluate the variations of OMC with cone beam computed tomography in CLP patients according to our literature research. In this thesis, we aimed to evaluate the anatomy and variations of OMC with cone beam computed tomography, one of the most widely used radiological imaging methods in dentistry by comparing CLP patients and healthy individuals and to reveal the anatomical differences in CLP patients. The variations of OMC, are group as conchal variations (concha bullosa, paradoxical and bifid turbinate), deviation and pneumatization of nasal septum, variations of uncinate process (uncinate bulla, bifid uncinate process, types according to orientation, deviation and the position of superior attachment), variations of ethmoid cells (Agger nasi cell, Haller cell, large ethmoid bulla), are compared in a hundred CLP patients without syndrome and in a hundred patients as a control group. The most common anatomic variation in this thesis was Agger nasi cell (99%) in the control group, Agger nasi cell and concha bullosa (97%) in the CLP group, and also the atelectatic uncinate process was the least observed variation in both groups. The incidences of bifid turbinate, uncinate bulla, bifid uncinate process, nasal septum deviation, deformity in chondrovomeral junction are higher in the CLP group than in the control group (p<0.05). However the incidences of pneumatization of nasal septum, bulbous concha bullosa are higher in the control group than in the CLP group (p<0.05). As a result, statistically significant differences are found between CLP and control groups, and three dimensional anatomy of OMC should be well known in order to guide surgical treatment. Key Words: Osteomeatal complex, anatomic variations, cleft lip palate, cone beam computed tomography.