Investigation of Maxillary Sinus Volume and Pathologies in Patients with Unilateral Cleft Lip and Palate Using Cone Beam Computed Tomography

Background: This study aimed to analyze the volumetric and morphological characteristics of the maxillary sinus in individuals with unilateral cleft lip and palate (CLP) using cone-beam computed tomography (CBCT) and to provide clinically relevant data to support surgical planning.Methods: Maxillary sinus volume, the presence of septa, nasal septum deviation (NSD), concha bullosa, and maxillary sinus pathologies were evaluated in unilateral CLP patients and healthy controls using CBCT images. Maxillary sinus volumes were calculated through manual segmentation with the ITK-SNAP software. First, comparisons were made between the CLP and control groups; subsequently, subgroup analyses were performed within the CLP group, comparing the cleft side and the non-cleft side.Results: A total of 36 CLP patients and 36 healthy controls were included. Although the mean maxillary sinus volume was lower in the CLP group, the difference was not statistically significant. Septa were more frequently observed in the control group (p = 0.012), whereas NSD was significantly more common in the CLP group (p < 0.001). Regarding maxillary sinus pathologies, mucosal thickening was significantly higher in the CLP group compared with controls (p < 0.001). In subgroup analysis, NSD was significantly more frequent on the cleft side (p = 0.003), while no significant differences were observed for other parameters.Conclusion: Evaluation of maxillary sinus volume, anatomical variations, and pathologies in adult CLP patients provides valuable insights for surgical planning. In particular, NSD and mucosal alterations should be carefully considered due to their potential clinical impact.Keywords: Maxillary sinus, cleft lip and palate, cone-beam computed tomography, ITK-SNAP, volumetric analysis