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Pharyngeal Dimensions And Obstructive Sleep Apnea in Individuals With Cleft Lip/Palate and Class III Malocclusion.


In individuals with CLP, maxillomandibular discrepancy occurs as a consequence of the deleterious effects of primary plastic surgeries (cheiloplasty and palatoplasty). While these surgeries offer clear benefits in restoring the shape and function of the structures affected by the malformation, they are paradoxically associated to maxillary growth impairment, leading to a typical concave face, characterized by class III malocclusion. The maxillary growth impairment, on the other hand, can lead to a reduction of upper airway dimensions.


The aim of the present study was to three-dimensionally evaluate the upper airway of individuals with cleft lip and palate and class III malocclusion and to correlate the findings with the occurrence of obstructive sleep apnea (OSA).


Twenty-one individuals with cleft lip and palate and class III malocclusion, aged 20 to 29 years old, who underwent cone beam computed tomography for orthognathic surgery planning were prospectively evaluated. All participants underwent polysomnography and the apnea-hypopnea index ≥5events/hour was considered indicative of OSA. The total upper airway, nasal cavity, pharynx and its subdivisions (naso, oro and hypopharynx) volumes, as well as the minimum pharyngeal cross-sectional area (CSA), were assessed using Mimics software.


Among the 21 individuals analyzed, 6(29%) presented OSA. The total upper airway and the oropharynx mean volumes were significantly decreased in subjects with OSA when compared to individuals without. Although smaller in the OSA group, mean nasopharynx volume and minimum CSA were not statistically different between groups.


Results showed that individuals with cleft lip and palate with class III malocclusion and OSA have an upper airway significantly smaller than individuals without OSA, especially in the region of the oropharynx.


Cleft palate, cone beam computed tomography, polysomnography, obstructive sleep apnea.


Área Clínica


Hospital de Reabilitação de Anomalias Craniofaciais - USP - Sao Paulo - Brasil, University of North Carolina at Chapel Hill - - Estados Unidos


Leticia Dominguez Campos, Inge Elly Kiemle Trindade, Marilia Yatabe, Sergio Henrique Kiemle Trindade, Luiz Andre Pimenta, Julia Kimbell, Amelia F Drake, Ivy Kiemle Trindade-Suedam