Evaluation of Nasolacrimal Canal Morphometric Features in Unilateral Cleft Palate Patients: A CBCT Study
Journal of Dental School,
Vol. 43 No. 4 (2025),
18 Mehr 2025
,
Page 210-215
https://doi.org/10.22037/jds.v43i4.47331
Abstract
Objective(s): The morphology and size of the nasolacrimal duct play essential roles in development of primary acquired nasolacrimal duct obstruction (PANDO), dacryocystitis, and Epiphora, in cleft palate patients. Furthermore, the treatment approaches for nasolacrimal duct obstruction require precise determination of the duct dimensions to select the most suitable treatment. The purpose of the present study was to assess the dimensions of the nasolacrimal duct in unilateral cleft palate patients through cone beam computed tomography (CBCT). Methods: In this observational-analytic study, 37 CBCT images of individuals with unilateral cleft were assessed. Nasolacrimal canal dimensions were measured at three segments; The entrance (proximal), narrowest part, and opening into the inferior meatus (distal) on the affected and unaffected sides. The length and angulation of the canal with the nasal floor were also assessed using OnDemand3D software. T-test and Shapiro-Wilk test were used for statistical data analysis at p<0.05. Results: The anterior-posterior dimension of the nasolacrimal canal in the distal segment was significantly lower on the affected side (p < 0.001). The mediolateral dimensions at the distal and narrowest segments were significantly lower on the affected side than the unaffected side (p = 0.03 and p = 0.04, respectively). No significant differences were observed between the surface area, length, or angulation of the nasolacrimal canal relative to the nasal floor on either sides (p > 0.05). Conclusion: The narrowest and distal segments of the nasolacrimal canal in unilateral cleft palate patients were significantly narrower compared to the unaffected side. This suggests an increased likelihood of conditions such as PANDO, dacryocystitis, epiphora, and other complications associated with a constricted duct in these individuals. However, the surface area, length, and angulation of the nasolacrimal canal in relation to the nasal floor were not influenced by the presence of a cleft palate.
- Cleft Palate
- Nasolacrimal Duct
- Cone Beam Computed Tomography
How to Cite
References
Salari N, Darvishi N, Heydari M, Bokaee S, Darvishi F, Mohammadi M. Global prevalence of cleft palate, cleft lip and cleft palate and lip: a comprehensive systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2022;123(2):110-20. doi:10.1016/j.jormas.2021.05.008
Anchlia S, Rao KS, Bonanthaya K, Anupama B, Nayak IV. Ophthalmic considerations in cleft lip and palate patients. J Maxillofac Oral Surg. 2011;10(1):14-9. doi:10.1007/s12663-010-0058-z
Lopes de Rezende Barbosa G, Pimenta LA, Pretti H, Golden BA, Roberts J, Drake AF. Difference in maxillary sinus volumes of patients with cleft lip and palate. Int J Pediat Otorhinolaryng. 2014;78(12):2234-6. doi:10.1016/j.ijporl.2014.10.019
Altun O, Dedeoglu N, Avci M. Examination of nasolacrimal duct morphometry using cone beam computed tomography in patients with unilateral cleft lip/palate. J Craniofac Surg. 2017;28(8):e725-8. doi:10.1097/scs.0000000000003848
Bulbul E, Yazici A, Yanik B, Yazici H, Demirpolat G. Morphometric evaluation of bony nasolacrimal canal in a caucasian population with primary acquired nasolacrimal duct obstruction: a multidetector computed tomography study. Korean J Radiol. 2016;17(2):271-6. doi:10.3348/kjr.2016.17.2.271
Shigeta K, Takegoshi H, Kikuchi S. Sex and age differences in the bony nasolacrimal canal: an anatomical study. Arch Ophthalmol. 2007;125(12):1677-81. doi:10.1001/archopht.125.12.1677
Lin AE, Chang YC, Lin MY, Tam KW, Shen YD. Comparison of treatment for congenital nasolacrimal duct obstruction: a systematic review and meta-analysis. Can J Ophthalmol. 2016;51(1):34-40. doi:10.1016/j.jcjo.2015.10.002
Jawaheer L, MacEwen CJ, Anijeet D. Endonasal versus external dacryocystorhinostomy for nasolacrimal duct obstruction. Cochrane Database Syst Rev. 2017;2(2):CD007097. doi:10.1002/14651858.cd007097.pub3
Mor JM, Matthaei M, Schrumpf H, Koch KR, Bölke E, Heindl LM. Transcanalicular laser dacryocystorhinostomy for acquired nasolacrimal duct obstruction: an audit of 104 patients. Eur J Med Res. 2018;23(1):58. doi:10.1186/s40001-018-0355-4
Yazici B, Yazici Z, Parlak M. Treatment of nasolacrimal duct obstruction in adults with polyurethane stent. Am J Ophthalmol. 2001;131(1):37-43. doi:10.1016/s0002-9394(00)00702-9
Janssen AG, Mansour K, Bos JJ, Castelijns JA. Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. AJNR Am J Neuroradiol. 2001;22(5):845-50.
Groell R, Schaffler G, Uggowitzer M, Szolar DH, Muellner K. CT-anatomy of the nasolacrimal sac and duct. Surg Radiol Anat. 1997;19(3):189-91. doi:10.1007/bf01627974
Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: combining digital technologies. Imaging Sci Dent. 2019;49(3):179–90. doi:10.5624/isd.2019.49.3.179
Vasegh Z, Safi Y, Azar MS, Ahsaie MG, Arianezhad SM. Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography–a cross sectional study. Head Face Med. 2023;19(1):47. doi:10.1186/s13005-023-00392-z
Fukushiro AP, Kiemle Trindade IE. Nasal airway dimensions of adults with cleft lip and palate: differences among cleft types. Cleft Palate Craniofac J. 2005;42(4):396-402. doi:10.1597/03-081.1
GÜLER AY, GÖKSEL S. Assessment of the volumetric features of nasolacrimal canal on patients with unilateral cleft lip and palate: a cone-beam computed tomography study. NEU Dent J. 2023;5(2):54-9. doi: 10.51122/neudentj.2023.58
Okumuş Ö. Investigation of the morphometric features of bony nasolacrimal canal: a cone-beam computed tomography study. Folia Morphol (Warsz). 2020;79(3):588-93. doi:10.5603/fm.a2019.0099
Groessl SA, Sires BS, Lemke BN. An anatomical basis for primary acquired nasolacrimal duct obstruction. Arch Ophthalmol. 1997;115(1):71-4. doi:10.1001/archopht.1997.01100150073012
Janssen AG, Mansour K, Bos JJ, Castelijns JA. Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. AJNR Am J Neuroradiol. 2001;22(5):845-50.
Jafari-Pozve N, Kiani H, Aryanezhad SS. Comparing dimensions of upper airway in patients with nasal septal deviation and healthy people in CBCT. Am J Nucl Med Mol Imaging. 2022;12(1):33-40.
- Abstract Viewed: 99 times
- PDF Downloaded: 75 times