Cephalometric Assessment of Craniofacial Structures in Patients with Cleft Lip and Palate

This retrospective study describes the craniofacial architecture of post-pubertal patients with cleft lip and palate by using DELAIRE whole skull analysis along with the analysis by SEGNER AND HASUND. 177 cephalometric X-ray films from a group of patients (114 male, 63 female) of the former Wolfgang Rosenthal Clinic Thallwitz, Germany, were analyzed. Typical changes in the viscerocranium (mandibular and maxillary retrognathia in a vertical basal open relationship) were accompanied by small yet statistically significant changes to the neurocranium. The study revealed midface deficits in the sagittal plane and a reduced height of the midface in favour of the lower face. Furthermore, a reduced craniofacial base line and cranial height and a reduced angle between the cranial base and craniofacial base line were evident. The angle between the cranial base and the basilar slope was enlarged, suggesting an abnormal posture of the cervical spine in CLP patients. Cleft lip and palate along with late-closure corrective surgery may cause complex effects on the entire craniofacial architecture, including, but not limited to, the facial region. Whole skull analyses - such as the DELAIRE analysis - are beneficial in assessing abnormal dimensions extending beyond the face and oral cavity to the entire viscerocranium and neurocranium in general, as might commonly occur in cleft lip and palate patients. Keywords: Cleft, delaire analysis, segner hasund analysis, whole skull analysis, craniofacial architecture, thallwitz