Tek taraflı dudak ve damak yarığı görülen bireylerde kraniyal kaide ve sella tursika morfolojisinin değerlendirilmesi

Amaç: Bu çalışmanın amacı, tek taraflı dudak damak yarıklı bireylerde (TDDY), kraniyal kaide ve sella tursikanın boyutlarını ve morfolojisini, maksiller yetersizliğe bağlı Sınıf III anomali gösteren bireyler (CL3) ve normal sınıf I kraniyofasiyal yapıya sahip bireyler (CL1) ile karşılaştırmaktır. Gereç ve Yöntem: Bu retrospektif çalışma, TDDY (10 kız, 4 erkek; 12.05±1.14 yıl), CL3 (10 kız, 5 erkek; 11.73±0.89 yıl) ve CL1 (10 kız, 5 erkek; 13.11±1.11 yıl) hasta gruplarına ait lateral sefalometrik radyografiler üzerinde yapıldı. Sella tursika ve kraniyal kaideye ait açısal ve doğrusal ölçümler radyografilere ait çizimler üzerinde yapıldı. Gruplar-arası karşılaştırmalarda tek yönlü ANOVA ve Tukey testi veya Bonferroni düzeltmesi ile Kruskal-Wallis testi kullanıldı (p<0.05); korelasyonlar için ise Spearman korelasyon analizi kullanıldı (p<0.01). Bulgular: Maksillanın efektif boyutu (Co-A) TDDY (p=0.035) ve CL3 (p=0.001) gruplarında CL1’e göre azalmış bulundu. Toplam kraniyal uzunluk (Ba-N), TDDY grubunda CL3’e (p=0.012) ve CL1’e (p=0.016)  göre artmış bulundu. Kraniyal kaide açısı (N-S-Ar°), CL3 grubunda TDDY (p=0.001) ve CL1’e (p=0.009) göre daha azdı. Ba-N (p=0.003) ve ön kafa kaidesi uzunluğu (S-N) (p=0.000) ile Co-A arasında ve arka kafa kaidesi uzunluğu (S-Ba) ile ramus yüksekliği (Ar-Go) (p=0.001) arasında pozitif korelasyonlar bulundu. Sella tursikanın çapının CL1 grubunda CL3’e göre daha fazla olduğu görüldü (p=0.025). Sella tursikaya ait morfolojik varyasyonlar TDDY grubunda kontrol gruplarına göre daha yüksek orandaydı (%71.4). Sonuç: TDDY grubunda maksiller yetersizliğe bağlı bir sınıf III maloklüzyon eğilimi olsa da, Sınıf III bireylerde görülen karakteristik kraniyal kaidedenin artmış fleksiyonu, TDDY grubunda görülmedi. Sella tursikanın boyutları TDDY ve CL3 varlığında önemli bir değişim göstermezken morfolojik varyasyonların TDDY grubunda daha fazla olduğu izlendi.

Evaluation of the cranial base and sella turcica morphology in patients with unilateral cleft lip and palate

Objective: The aim of this study was to investigate the size and morphology of the sella turcica and cranial base in individuals with unilateral cleft lip and palate (UCLP), and to compare it with individuals showing Class III discrepancy due to maxillary deficiency (CL3) and with individuals having normal (CL1) craniofacial development. Materials and Method: This retrospective study was carried out on the lateral cephalogram tracings of UCLP (10 females, 4 males; 12.05±1.14 years), CL3 (10 females, 5 males; 11.73±0.89 years) and CL1 (10 females, 5 males; 13.11±1.11 years) patients. Linear and angular measurements related to sella turcica and cranial base were performed. Intergroup comparisons were either made with one-way ANOVA followed by Tukey’s test or with Kruskal-Wallis test with Bonferroni adjustment (p<0.05). Spearman correlation coefficient was used for correlations (p<0.01). Results: The length of the maxilla (Co-A) was shorter in UCLP (p=0.035) and CL3 (p=0.001) than in CL1. Total cranial length (Ba-N) was greater in UCLP than in CL3 (p=0.012) and CL1 (p=0.016). Cranial base angle (N-S-Ar°) was less in CL3 than in UCLP (p=0.001) and CL1 (p=0.009). Ba-N (p=0.003) and anterior cranial length (S-N) (p=0.000) were positively correlated with Co-A. Posterior cranial length (S-Ba) was positively correlated with ramus height (Ar-Go) (p=0.001). The diameter of sella was bigger in CL1 than in CL3 (p=0.025). The prevalence of morphologic variations of sella turcica in UCLP was higher (71.4%) than in control groups. Conclusion: Although there was a Class III tendency in UCLP due to maxillary deficiency, cranial base flexure characteristic to CL3 anomalies was not seen in this group. The existence of UCLP or CL3 did not alter dimensions of sella turcica, but morphologic variations were more common in UCLP.

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