UNILATERAL DUDAK DAMAK YARIKLI HASTALARDA MAKSILLER SINÜS HACIM VE YÜZEY ALANININ KONIK IŞINLI BILGISAYARLI TOMOGRAFI KULLANILARAK DEĞERLENDIRILMESI

Yıl 2021, Cilt: 31 Sayı: 1, 1 - 7, 15.01.2021

Serkan Yılmaz Mehmet Amuk

https://doi.org/10.17567/ataunidfd.807512

Öz

Amaç: En önemli konjenital gelişimsel bozukluklardan biri olan dudak damak yarığı, primer damak oluşumu sırasında adezyon eksikliğine bağlı olarak fetal dönemin başında oluşur. Dudak damak yarıklı hastalarda maksiller sinüzit yaygın olarak görüldüğü için son zamanlarda bu hastaların maksiller sinüsleri ile ilgili çalışmalar artmıştır. Bu çalışmanın amacı, sendromsuz ve sağlıklı kontrol grubu bireylerin maksiller sinüs hacimleri ve yüzey alanları ile unilateral dudak damak yarıklı bireylerin maksiller sinüslerinin hacimleri ve yüzey alanlarının karşılaştırılmasıdır.
Gereç ve Yöntem: Çalışmada 30 unilateral dudak damak yarıklı hasta ile 30 sağlıklı ve sendromsuz bireyin Konik Işınlı Bilgisayarlı Tomografi görüntüleri kullanılmıştır. Kontrol grubu KIBT görüntüleri herhangi bir diş tedavisi nedeniyle alınmış olan retrospektif görüntülerden seçilmiştir. Kontrol grubu oluşturulurken çalışma grubuna uyumlu olacak şekilde yaş ve cinsiyet tercihinde bulunulmuştur. Dicom görüntüler, Simplant Pro 16 yazılımında değerlendirilerek hacim ve yüzey alanı ölçümleri aynı standartlarda yapılarak kaydedilmiştir.
Bulgular: Grupların cinsiyet ve yaş dağılımları arasında istatistiksel olarak anlamlı fark yoktur. Hasta grubunun yaş ortalaması (13.4) ve kontrol grubunda yaş ortalaması (15.3) olarak bulunmuştur. Gruplar arası karşılaştırmada ise UDDY’li bireylerin 23 tanesinde sol taraf yarık hattı olup 7 tanesinde yarık hattı sağ tarafta izlenmiştir. Çalışma ve kontrol grubu arasında sağ maksiller sinus hacminin anlamlı bir değişim göstermemiştir. (p=0.178). Ancak sol maksiller sinus hacim değerleri kontrol grubunda daha yüksek bulundu ve anlamlı bir fark görülmüştür. (p=0.01). Maksiller sinüs alanı ortalamaları karşılaştırıldığında, sol maksiller sinus alanı kontrol grubunda hasta grubundan anlamlı bir farkla yüksek bulunmuştur. (p=0.046)
Sonuç: Dudak damak yarıklı hastalarda maksiller sinüs hacminin ve yüzey alanının sağlıklı bireye göre daha düşük olması maksiller sinüs bölgesindeki preoperatif ve post operatif cerrahi işlemler önem arz etmektedir.

Anahtar Kelimeler: Dudak Damak Yarığı, Maksiller Sinüs,Konik Işınlı Bilgisayarlı Tomografi

Evaluation of the Maxillary Sinus Volume and Surface Area in Patients with Unilateral Lip and Palate Cleft Using Cone Beam Computed Tomography
Aim: Cleft lip and palate which is one of the most important congenital disorders occurs at the beginning of the fetal period due to adhesion deficiency during primary palate formation. Since maxillary sinusitis is common in patients with cleft lip and palate, recently studies on the maxillary sinuses of these patients have increased. The aim of this study is to compare the maxillary sinus volumes and surface areas of the healthy individuals without syndrome and those of the individuals with unilateral cleft lip and palate.
Material and Methods: Cone Beam Computed Tomography images of 30 healthy individuals without syndrome and 30 individuals with cleft lip and palate were used in this study. Control group CBCT images were selected from retrospective images which have been taken due to any dental treatment. Control group was selected to be compatible with the study group in terms of age and gender. Dicom images were evaluated in the Simplant Pro 16 software, and volume and surface area measurements were performed to the same standards and recorded.
Results: There was no statistically significant difference between groups' gender and age distribution. The average age of the patient group (13.4) and the control group (15.3) were found. In comparison of the groups, 23 of the individuals with cleft had a left side cleft and 7 of them had a cleft on the right side. It was observed that the right maxillary sinus volume did not differ significantly between the patient and control groups(p=0.178). However, left maxillary sinus volume values were higher in the control group and there was a significant difference. (p=0.01) When the maxillary sinus area averages were compared, the left maxillary sinus area was found higher in the control group with a significant difference from the patient group. (p=0.046)
Conclusion: Maxillary sinus volume and surface area in patients with cleft lip and palate have been found to be negatively affected. Thats why preoperative and post-operative surgical procedures are considerable in the maxillary sinus area.
Keywords: Cleft Lip and Palate, Maxillary Sinus, Cone Beam Computed Tomography

Anahtar Kelimeler

Dudak Damak Yarığı, Maksiller Sinüs, Konik Işınlı Bilgisayarlı Tomografi

Kaynakça

• 1. Koppe T, Weigel C, Baerenklau M, Kaduk W, Bayerlein T, Gedrange T. Maxillary sinus pneumatization of an adult skull with an untreated bilateral cleft palate. J Cranio-Maxillofac Surg 2006;34:91-5.
• 2. Rong M. Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients. Kokubyo Gakkai Zasshi 1994;61:492-511.
• 3. Hikosaka M, Nagasao T, Ogata H, Kaneko T, Kishi K. Evaluation of maxillary sinus volume in cleft alveolus patients using 3-dimensional computed tomography. J Craniofac Surg 2013;24:23-6.
• 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.
• 5. Robinson HE, Zerlin GK, Passy V. Maxillary sinus development in patients with cleft palates as compared to those with normal palates. Laryn 1982;92:183-7.
• 6. Francis P, Raman R, Korula P, Korah I. Pneumatization of the paranasal sinuses (maxillary and frontal) in cleft lip and palate. Archives of Otolaryngology–Head & Neck Surg 1990;116:920-2.
• 7. Smith TD, Siegel MI, Mooney MP, Burrows AM, Todhunter JS. Formation and enlargement of the paranasal sinuses in normal and cleft lip and palate human fetuses. Cleft Palate Craniofac J 1997; 34: 483-9.
• 8. Schneiderman ED, Xu H, Salyer KE. Characterization of the maxillary complex in unilateral cleft lip and palate using cone-beam computed tomography: a preliminary study. J Craniofac Surg 2009;20:1699-710.
• 9. Erdur O, Ucar FI, Sekerci AE, Celikoglu M, Buyuk SK. Maxillary sinus volumes of patients with unilateral cleft lip and palate. Int J Pediat Otorhinolaryngol 2015;79:1741-4.
• 10. de Rezende Barbosa GL, Pimenta LA, Pretti H, Golden BA, Roberts J, Drake AF. Difference in maxillary sinus volumes of patients with cleft lip and palate. Int J Pediatr Otorhinolaryngol 2014; 78: 2234-6.
• 11. Shah RK, Dhingra JK, Carter BL, Rebeiz EE. Paranasal sinus development: a radiographic study. The Laryngoscope. 2003;113:205-9.
• 12. Karakas S, Kavaklı A. Morphometric examination of the paranasal sinuses and mastoid air cells using computed tomography. Ann Saudi Med 2005; 25: 41-5.
• 13. Deeb R, Malani PN, Gil B, Jafari-Khouzani K, Soltanian-Zadeh H, Patel S, et al. Three-dimensional volumetric measurements and analysis of the maxillary sinus. Am J Rhinol & Allergy 2011; 25: 152-6.
• 14. Havlova Z, Brejcha V, Hajnis K, Růzicková J. Development of sinus maxillaris in children with complete unilateral clefts.(Age class 4-7 years). Acta Chirurgiae Plastic 1970;12:65-76.
• 15. Ariji Y, Kuroki T, Moriguchi S, Ariji E, Kanda S. Age changes in the volume of the human maxillary sinus: a study using computed tomography. Dentomaxillofac Radiol 1994;23:163-8.
• 16. Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K. Computed tomography measurements of different dimensions of maxillary and frontal sinuses. BMC Med Imaging 2011;11:8.
• 17. Som P, Curtin H. An updated and illustrated review of the complex embryology of the larynx and how laryngeal webs, atresias, and stenoses develop. Neurograph 2014;4:189-203.
• 18. Büyükkoçak BK, Paksoy CS. Retrospective Evaluation of the relationship between volumes of paranasal sinuses, presence of rhinosinusitis and nasal septum deviations on cbct images. Atatürk Üniv Diş Hek Fak Derg 2019;29:550-5.
• 19. Suzuki M, Watanabe T, Suko T, Mogi G. Comparison of sinusitis with and without allergic rhinitis: characteristics of paranasal sinus effusion and mucosa. Am J Otolaryngol 1999;20:143-50.
• 20. Suzuki H, Yamaguchi T, Furukawa M. Maxillary sinus development and sinusitis in patients with cleft lip and palate. Auris Nasus Larynx 2000; 27:253-6.
• 21. Agarwal R, Parihar A, Mandhani PA, Chandra R. Three-dimensional computed tomographic analysis of the maxilla in unilateral cleft lip and palate: implications for rhinoplasty. J Craniofac Surg 2012; 23:1338-42.
• 22. Demirtas O, Kalabalik F, Dane A, Aktan AM, Ciftci E, Tarim E. Does unilateral cleft lip and palate affect the maxillary sinus volume? Cleft Palate Craniofac J 2018;55:168-72.
• 23. Salib R, Chaudri S, Rockley T. Sinusitis in the hypoplastic maxillary antrum: the crucial role of radiology in diagnosis and management. J Laryngol Otol 2001;115:676-8.