Evaluation of Pharyngeal Airway Dimensions in a Sample of Jordanian Preadolescent Cleft Lip and Palate Patients before Orthognathic Surgery

Objective: To exam the pharyngeal airway dimensions in cleft lip and palate subjects and to compare them with controls before orthognathic surgery and to assess the need for orthognathic surgery for these cases. Material and methods: Pre-orthodontic cephalograms of two hundred patients were used in this study. Twenty one landmarks for sagittal pharyngeal airway and soft tissue measurements had been identified for each cephalogram. Patients were selected according to the specific inclusion criteria and divided into 2 groups according to the presence of cleft lip and palate. The first group was Jordanian cleft lip and palate and consisted of 100 subjects (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.4 ± 2.4 years), and the second group was 100 controls without cleft lip and palate (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.7 ± 2.2 years). Independent t-test was used to detect differences between the two groups. Results: Subject's pharyngeal airway dimensions were significantly narrower, in the lower airway thickness (PNS - AD1) (P= 0.000), upper airway thickness (PNS - AD2) (P= 0.000), total lower sagittal depth of the bony nasopharynx (PNS - Ba) (P= 0.000), posterior sagittal depth of the bony nasopharynx (Ptm - Ba) (P= 0.000), total upper airway thickness (PNS - H) (P= 0.000) and McNamara's lower pharynx dimension (P= 0.007) when compared to control. On the other hand, control group showed significantly longer soft palate (PNS–P) (P= 0.000), and wider in both thickness of tongue (TGH) and soft palate (MPT) with (P= 0.000). The Tongue Length (TGL) and hyoid bone position did not record any significant difference when compared to subject group. Conclusions: Subjects had narrower pharyngeal airway dimensions when compared with the controls and this was not due to soft tissue hypertrophy but attributed to the smaller bony nasopharyngeal framework and skeletal deformations. Orthognathic surgery is indicated in cleft lip and palate population to correct skeletal discrepancies.