Three-dimensional evaluation of the airway spaces in patients with and without cleft lip and palate: A digital volume tomographic study

Patients with cleft lip and palate (CLP) suffer from several esthetic and functional challenges. Comprehensive treatment of these patients involves orthognathic surgery that may lead to velopharyngeal insufficiency or reduction in lower airway. Several cases of airway insufficiency, velopharyngeal incompetence, snoring, hypopnea, and obstructive sleep apnea have been reported in subjects with CLP. The aim of this study was to compare the anteroposterior dimensions of the oropharyngeal airway at 5 levels, the height of the oropharyngeal column, and the volume of the oropharyngeal airway in subjects with and without CLP. The sample consisted of 62 patients with CLP and 42 subjects with Angle Class I malocclusion. Anteroposterior dimension, height, and volume of the oropharyngeal airway were measured using the midsagittal and axial slices obtained from 3-dimensional digital volume tomographic scans for both groups. The anteroposterior dimensions of the airway were significantly reduced in the study subjects compared with the control group at the level of the postnasal spine, the base of the tongue, and the epiglottis. The airway dimensions measured on the axial sections at the level of the palatal and epiglottic plane were also significantly lower in the study group. The height and volume of the oropharyngeal airway were also significantly smaller in patients with CLP compared with subjects without CLP. Patients with CLP showed reduced dimensions and volumes of the oropharyngeal airway in all 3 planes compared with the control group. •AP airway space dimension was significantly smaller in CLP patients than in controls.•Subjects with CLP had shorter oropharyngeal airway height than controls.•Oropharyngeal airway volume was lower in CLP patients than in controls.•A “compensation hypothesis” is suggested for oropharyngeal airway in CLP patients.