Premaxillary protrusion assessment by the maxilla-nasion-mandible angle in fetuses with facial clefts.
de Jong-Pleij, E. A. P. 1,*; Pistorius, L. R. 2; Ribbert, L. S. M. 1; Breugem, C. C. 3,4; Bakker, M. 5; Tromp, E. 6; Bilardo, C. M. 5,7
[Article] Prenatal Diagnosis. 33(4):354-359, April 2013.

(Format: HTML, PDF)

Objective: The aim of the study was to measure the degree of premaxillary protrusion in fetuses with orofacial clefts of various severities.

Methods: The maxilla-nasion-mandible (MNM) angle was measured retrospectively on by multiplanar corrected volumes. Sixty-two fetuses with orofacial clefts and known outcome volumes of the fetal head were available.

Results: In 48 of the 62 cases, the MNM angle could be measured [mean gestational age 23 (range, 18-30) weeks]. The mean MNM angle was normal in all nine cases with cleft lip and intact alveolar ridge (15.2[degrees]; range, 12.5[degrees]- 16.9[degrees]). In 24 cases with unilateral cleft lip with or without cleft palate (UCL/P), the mean MNM angle was 20.0[degrees] (range, 13.3-26.2[degrees]), being above the 95th percentile in 79% (n = 19) and normal in 21% (n = 5). In 14 bilateral cleft lip and palate (BCL/P) cases, the mean MNM angle was 26.5[degrees] (range, 19.2[degrees]-33.7[degrees]) and above the 95th percentile in all cases. There was no difference in MNM angle between isolated clefts and clefts associated with other anomalies. In one case with a Tessier 4 cleft, the MNM angle was above the 95th percentile (25.2[degrees]).

Conclusion: The premaxilla tends to protrude in both BCL/P as UCL/P cases. The degree of protrusion varies greatly, especially in the BCL/P group. (C) 2013 John Wiley & Sons, Ltd.

Copyright (C) 2013 John Wiley & Sons, Inc.