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Internal nasal dimensions of children with unilateral cleft lip and palate and maxillary atresia: acoustic rhynometry technique validation by means of cone beam computed tomography

Grant number: 17/12789-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): November 01, 2017
Effective date (End): August 31, 2019
Field of knowledge:Health Sciences - Dentistry
Principal researcher:Ivy Kiemle Trindade Suedam
Grantee:Caroline Akemi Hassegawa
Home Institution: Hospital de Reabilitação de Anomalias Craniofaciais (HRAC). Universidade de São Paulo (USP). Bauru , SP, Brazil

Abstract

Cleft lip and palate (CLP) is the most prevalent congenital malformation in humans. The surgical closure of the lip and palate, which aims to restore shape and function, paradoxically, negatively impacts on maxillary growth and, consequently, on nasal morphophysiology, leading to deformities such as septal deviation and nasal turbinate hypertrophy. These changes reduce the internal dimensions of the nasal cavity and increase resistance to respiratory airflow. A previous study (FAPESP 2015 / 20906-0) showed that the internal nasal dimensions of individuals with CLP were reduced when compared to individuals without CLP, by means of cone beam computed tomography (CBCT). The assessment of the upper airways using CBCT involves, however, the emission of ionizing radiation to the patient, making it unfeasible to use it in the daily clinical practice. Therein lies the great advantage of acoustic rhinometry, which allows the evaluation before and after treatment, without any risks, in a painless and non-invasive way. However, although widely used, it is well known that the rhinometry technique has never been validated by means of a comparison with computed tomography, considered the gold standard for evaluation of internal nasal volumes. Thus, the aim of the present study is to analyze the internal geometry of the nasal cavity of children with CLP and maxillary deficiency using of two methods: cone beam computed tomography, the gold standard method, and acoustic rhinometry, and to compare them. For this, a cross-sectional and prospective CBCT and acoustic rhinometry exams, previously obtained for orthodontic planning purposes, of 20 children with CLP and maxillary atresia will be evaluated. Through the software Dolphin Imaging 11.8 the nasal cavity will be segmented and the nasal internal volumes will be obtained. It is our hypothesis that acoustic rhinometry has the same ability to provide reliable information about nasal cavity dimensions such as computed tomography. (AU)

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