Cleft lip and palate reconstructive surgery- influence on development of mastoid bone pneumatization
Abstract Objectives:To estimate correlation between size and growing rate of mastoid bone pneumatization (MBP) according to severity of cleft lip and palate types and age subgroups. Method: Measurement and comparation of mastoid bone pneumatization sizes performed for ears of different cleft lip and palate types and age subgroups on x-ray pictures (made according to Schuller technique) planimetrically. Study group include ears with confirmed otitis media with effusion (OME) of 14 bilateral (BCLP), 58 unilateral cleft lip and palate (UCLP) and 74 children with isolated cleft palate (ICP) ,(median age 6.0years). and control group of 52 non-cleft children suffered of recurrent episodes of OME (median age of 6.0yr). Comparation of size of MBP of left vs. right ears for different age groups performed in different cleft lip and palate types. Results: Size of MBP for total group of tested cleft palate ears was (7.3cm2), that is significantly smaller than MBP for total group of OME ears (8.12cm2) (p=0.0018). MBP in OME ears (8.12cm2) was bigger than in separate cleft type ears: BCLP (6,5cm2, p=0.0042), UCLP (7.4cm2, p=0.0052) and ICP (7,2cm2 p=0.0022). MBP in SOM ears showed faster rate of pneumatization growth (development) with aging(r=0.293, p=0.0035) than total group of cleft palate ears ( r=0.174,p=0.003). Mastoid bone pneumatization in BCLP and UCLP have smallest MBP size which do not grow significantlly with aging.MBP in isolated cleft palate have highest size if compared with other cleft types.This is only cleft tzpe with significant growing of MBP with aging. Conclusion: Cleft types with highest severy of structural defects bilateral and unilateral cleft lip and palate have smalest MBP , and no tendency of growth in size with aging.Ears of children of isolated cleft palate type showed higher size and growing rate of MBP with aging than. High severity and structural defects in BCLP and UCLP are accompanied with retardation of development and growth of MBP, what makes them of high risk for further frequent infflamations and reccurence of OME,That contributes to retardation or/and slower development of mastoid pneumatization.