Morphometric analysis of the maxillofacial region for Le Fort I osteotomy in patients with cleft lip and palate

Patients with cleft lip and palate (CLP) exhibit complex maxillary morphology, including hypoplasia, making Le Fort I osteotomy challenging and prone to complications. The aim of this retrospective, comparative study was to improve the safety of Le Fort I osteotomy by analysing the maxillary structure of patients with CLP. Fifteen unilateral CLP cases with maxillary hypoplasia (six males, nine females) and 15 non-CLP cases undergoing mandibular setback for prognathism (four males, 11 females) were evaluated. Axial computed tomographic (CT) images at 2.5 and 5 mm above the nasal floor were analysed. Ten parameters were measured, focusing on the distances between key anatomical landmarks including lateral and medial pterygoid plates and posterior maxillary sinus wall to pterygoid fossa. In the CLP group, the distance between the lateral and medial pterygoid plates was 4.8 ± 1.2 mm (healthy side) and 5.4 ± 1.3 mm (afflicted side), compared with 6.4 ± 1.2 mm in the non-CLP group. The shortest distance between the posterior maxillary sinus wall and pterygoid fossa was 2.7 ± 1.1 mm (healthy side) and 2.9 ± 1.3 mm (afflicted side) in CLP group, significantly greater than 1.9 ± 0.3 mm in non-CLP group. These findings indicate a thicker pterygomaxillary junction in patients with CLP, which highlights key anatomical differences. Understanding these features may help reduce surgical complications during Le Fort I osteotomy in patients with CLP.