Three-Dimensional Morphometric Analysis of the Maxillary Sinus-Nasal Complex in Adolescents With Unilateral Cleft Lip and Palate Using Cone‑Beam Computed Tomography.

OBJECTIVE: Unilateral cleft lip and palate (UCLP) often causes craniofacial asymmetry and maxillary growth disturbance, but differences in the maxillary sinus-nasal complex between cleft and noncleft sides remain unclear. This study used cone‑beam computed tomography (CBCT) to evaluate three‑dimensional features of the maxillary sinus, nasal septum, and nasolacrimal duct in adolescents with UCLP. METHODS: Preoperative CBCT scans of 50 nonsyndromic adolescents with UCLP aged 9 to 15 years were retrospectively analysed. The maxillary sinus height, width, depth, volume, primary ostium opening diameter, mucosal thickness and morphology, nasal septal deviation angle, and nasolacrimal duct dimensions and patency were assessed by two observers. Paired comparisons were performed between the cleft and noncleft sides. RESULTS: The cleft side demonstrated significantly reduced maxillary sinus height (26.10 ± 4.42 vs 28.60 ± 3.57 mm; P < .0001) and volume (12.50 ± 3.92 vs 13.09 ± 3.74 cm³; P = .0079) compared with the noncleft side. In contrast, no significant interside differences were observed in sinus width, depth, or primary ostium diameter. Nasal septal deviation toward the cleft side was identified in all patients. No significant differences were found between sides in sinus mucosal thickness, mucosal morphology, or nasolacrimal duct patency. CONCLUSIONS: Adolescents with UCLP exhibit asymmetry of the maxillary sinus-nasal complex, characterized primarily by reduced maxillary sinus height and volume on the cleft side together with consistent nasal septal deviation toward the cleft side. These findings provide further insight into craniofacial developmental characteristics in UCLP and may support more targeted multidisciplinary treatment planning during adolescence.