Impacto da protração maxilar nas vias aéreas e do software na avaliação do complexo nasal em tomografia computadorizada de pacientes com fissura de lábio e/ou palato

Abstract

Article 1: Objective: To compare Dolphin Imaging and 3D Slicer evaluating reconstructions made using computed tomography (CT) images of nasal septum deviation (NSD), concha hypertrophy and nasal cavity volume in patients with cleft lip and/or palate (FL/P) before (T1) and after (T2) alveolar bone graft. Methods: Medical records and craniofacial CT images of 12 patients with CL/P between 9 and 24 years of age attending a support center were collected. After orientation of the images, measurements of the NSD and nasal concha hypertrophy were performed, in addition to the evaluation of the volume of the nasal cavity. (P < 0.05), a statistical analysis was performed using the Wilcoxon test. Results: The medians of all groups represent the NSD level. Most comparisons do not show statistically related differences, except for T1 and T2 in the Dolphin software (p = 0.026). There were no significant differences compared to right and left concha hypertrophy. Nasal cavity volume assessment showed no difference within the software; however, statistical differences comparing T1 (p = 0.034) and T2 (p = 0.015) for both software. Article 2: Objective: To synthesize the effects of maxillary protraction on the dimensions of the upper airways of growing patients with CLP. Methods: The systematic review was conducted in accordance with the 2020 Statement of Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA). The search was conducted in MEDLINE, EMBASE, LILACS, Web of Science and Scopus until February 2021. Additional literature was identified in Google Scholar, Proquest and manual searches of bibliographies of the included studies. After removing the duplicates, the studies were selected for full reading to confirm their eligibility, and as required information from the selected articles was collected. ROBINS-I (the risk of bias in nonrandomized intervention studies) was used to assess the included studies. A qualitative synthesis of the included studies was performed, however, quantitative synthesis was not feasible. Results: After searching the database, 530 results were identified. Only nine articles were selected for full-text review, launching into 4 included studies. Necessary heterogeneity in the assessment of the dimension of the upper airways was obtained. Regarding the assessment of risk of bias, three studies were classified as having moderate risk of bias and one with serious risk of bias. The four studies differences before and after maxillary protraction. Conclusions: The software used cannot be conducted if it considers the assessment of the nasal complex in patients with CL / P. Although there was some variability between the software in relation to nasal cavity volume and nasal septum deviation, as differences may not be considered clinically relevant. Furthermore, based on low levels of evidence, how upper airway dimensions with FLP may change with maxillary protraction, but the magnitude of the changes is unlikely to be clinically relevant. Furthermore, there was no consistency in the changes.