Unilateral alveolar cleft size on prenatal 2-D ultrasonography predicts cleft of the secondary palate in fetal unilateral cleft lip: A Pilot Study

Eva Rubio, Radiology Department at Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Esperanza Mantilla-Rivas, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Monica Manrique, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Kenneth L. Fan, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Anna Blask, Radiology Department at Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Erin M. Rada, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Dorothy Bulas, Radiology Department at Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Marney A. White, Radiology Department at Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Gary F. Rogers, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Albert K. Oh, Division of Plastic and Reconstructive Surgery. Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.

Document Type

Journal Article

Publication Date

3-21-2023

Journal

Plastic and reconstructive surgery

DOI

10.1097/PRS.0000000000010437

Abstract

BACKGROUND: Prenatal diagnosis of cleft palate (CP) is challenging. The current study's objective was to investigate if prenatal alveolar cleft width is associated with the likelihood of a cleft of the secondary palate in unilateral cleft lip (CL). METHODS: The authors reviewed 2D US images in fetuses with unilateral CL from 1/2012-2/2016. Images of the fetal face were obtained with a linear and/or curved probe in the axial and coronal planes. Measurements of the alveolar ridge gap were taken by the senior radiologist. Post-natal phenotype findings were compared with prenatal findings. RESULTS: Thirty patients with unilateral CL met inclusion criteria; average gestational age was 26.67 ± 5.11 weeks (range 20.71, 36.57 weeks). Ten fetuses were found to have an intact alveolar ridge by prenatal US; postnatal exam confirmed intact secondary palate in all. Small alveolar defects <4 mm were noted in 3 fetuses; postnatal examination documented CP in a single patient. CP was confirmed in 15 of the remaining 17 fetuses who had alveolar cleft width >4 mm. An alveolar defect ≥ 4 mm on prenatal US was associated with greater likelihood of a cleft of the secondary palate (c 2 (2, n=30) = 20.23, p<.001). CONCLUSION: In the setting of unilateral CL, prenatal US documentation of alveolar defects ≥4 mm are highly predictive of the presence of a cleft of the secondary palate. Conversely, an intact alveolar ridge is associated with an intact secondary palate.

Department

Pediatrics

Link to Full Text

Share

COinS