POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information and conflict of interest References

ECR 2024 / C-14406

Seeing beyond the surface: the significance of imaging in cleft lip and palate diagnosis and treatment

Congress:

ECR 2024

Poster Number:

C-14406

Type:

Educational Exhibit

Keywords:

Anatomy, Head and neck, Paediatric, Cone beam CT, CT, Diagnostic procedure, Congenital

Authors:

A. Aranaz Murillo, P. Briceño Torralba, M. B. Fernández Lago, E. Pascual Perez, E. Sierra Beltrán, B. Izquierdo Hernández

DOI:

10.26044/ecr2024/C-14406

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-14406

Learning objectives

To highlight the role of imaging in diagnosing patients with cleft lip and palate (CLP) and its importance in treatment decision-making and post-treatment evaluations.

Background

Orofacial clefts are one of the most common congenital anomalies. On average, they occur in 1 out of 700 live births, but their incidence varies widely across different ethnicities and regions (in northern Europe, 1 in 500, and the African continent, 1 in 2,500).[1,2] Orofacial clefts are classified into three types based on their clinical manifestations, recurrence patterns, and biological knowledge, cleft lip (CL, 25%), cleft lip and palate (CLP, 50%), and cleft palate (CP, 25%). CL and CLP are considered part of a spectrum...

Findings and procedure details

Syndromic and Non-syndromic CL/PThere are two clinical types of CLP - Nonsyndromic and Syndromic. Nonsyndromic forms refer to cases where there are no other evident anomalies or features, accounting for around 50% of CP cases and 70% of CL and CLP cases. On the other hand, syndromic forms have additional manifestations, and their causative genes have been characterized. [1,5]Of these syndromes, velocardiofacial syndrome is the most common microdeletion syndrome, affecting the 22q11 region. It commonly includes abnormalities of the palate (60–80% usually manifested as a...

Conclusion

Imaging is a crucial aspect of the diagnosis and follow-up of patients with CLP. CT scans, in particular, provide valuable information that helps in treatment decisions and assessing outcomes. With advancements in imaging techniques, we are better equipped to understand the condition and develop effective treatment strategies, ultimately leading to improved patient care.

Personal information and conflict of interest

A. Aranaz Murillo: Nothing to disclose P. Briceño Torralba: Nothing to disclose M. B. Fernández Lago: Nothing to disclose E. Pascual Perez: Nothing to disclose E. Sierra Beltrán: Nothing to disclose B. Izquierdo Hernández: Nothing to disclose

References

Ysunza PA, Repetto GM, Pamplona MC, Calderon JF, Shaheen K, Chaiyasate K, et al. Current controversies in diagnosis and management of cleft palate and velopharyngeal insufficiency. Biomed Res Int. 2015;2015:196240. http://dx.doi.org/10.1155/2015/196240 Yates D, Allareddy V, Caplin J, Yadav S, Markiewicz MR. An overview of timeline of interventions in the continuum of cleft lip and palate care. Oral Maxillofac Surg Clin North Am. 2020;32(2):177–86. http://dx.doi.org/10.1016/j.coms.2020.01.001 Sidman J, Block W, Wirtz N. Clefting of the alveolus: Emphasizing the distinction from cleft palate. Am J Perinatol. 2016;33(06):531–4. http://dx.doi.org/10.1055/s-0036-1572537...

Fig 1: Facial CT. A and B) Volume rendering reconstruction. C) axial CT. Left cleft...

Fig 2: Facial CT. A) coronal reconstruction. B and C) Volume rendering reconstruction....

Fig 3: Facial CT. A) Volumen rendering reconstruction and B) Expanded and oblique...

Fig 4: Facial CT. A) Volumen rendering reconstruction and B) Expanded and oblique...

Fig 5: Facial CT. A) Volume rendering and B) axial CT. An alveolar cleft in the left...

Fig 6: Schematic drawings explaining embryological development. A) 5-week embryo. B)...

Fig 7: Schematic drawings explaining embryological development. The process of...

Fig 8: Schematic drawings of different clefts. A) Normal. B) Cleft lip. C) Unilateral...

Fig 9: Facial CT. It is sometimes difficult to differentiate between alveolar clefts...

Fig 10: Surgery timeline. Based on the information in Yates D, Allareddy V, Caplin J,...

Fig 11: Frontonasal dysplasia type 3. The patient presented with...

Fig 12: Facial CT. A) Volumen rendering and B) Expanded and oblique coronal...

Fig 13: Schematic drawings of different facial clefts. Based on Tessier P. Anatomical...

Fig 14: A) Schematic drawing of Tessier 0. B) Volumen rendering, C) coronal...

Fig 15: A) Schematic drawing of Tessier 1. B) expanded and oblique coronal...

Fig 16: A) Schematic drawing of Tessier 2. B) volume rendering, C) expanded and oblique...

Fig 17: A) Schematic drawing of Tessier 3. B) expanded and oblique coronal...

Fig 18: Facial CT. A) expanded and oblique coronal reconstruction, B, C, and D)...

Fig 19: A) Facial CT in 2021 after cleft palate surgery (square). B) and C) Facial CT...

Fig 20: Facial CT for control of surgical bone graft in the anterior region of the...

Fig 21: Facial CT two years after Fig 20. A) Volumen rendering, B) MIP bone...

Fig 22: A) Orthopantomography. B) Hyrax expander volume reconstruction. C) Maxillary...