Glenoid fossa position in surgically repaired unilateral cleft lip and palate patients.

Background: Relative position of the glenoid fossa would play a significant role in the morphology of lower face. The aim of the present study was to cephalometrically evaluate the position of the glenoid fossa in a group of unilateral cleft lip and palate (UCLP) patients in order to better clarify the role of this craniofacial component in skeletal disharmonies associated with this anomaly.

Methods: Lateral cephalometric radiographs of 59 patients (32 males and 27 females) with surgically repaired UCLP (mean age 19.5±1.4 years) along with an equal number of age and gender matched skeletal Class I controls were analyzed for sagittal and vertical position of the glenoid fossa as well as lower anterior face height (LAFH), mandibular plane and length.

Results: Paired samples t-test revealed a statistically significant anterior positioning of the glenoid fossa in UCLP subjects. A more cranial positioning of the glenoid fossa, basion, pterygomaxillary fissure, and posterior nasal spine were also seen to be associated with the cleft group on vertical evaluation. Effective length of mandible was normal with significantly steeper mandibular plane and increased LAFH.

Limitations: Further investigations using three dimensional imaging techniques is necessary for better clinical interpretation.

Conclusions: The glenoid fossa is positioned more cranially and anteriorly in UCLP individuals, clinically contributing to the mandibular prominence and concave facial profile inspite of their mandibular length being normal. Steep mandibular planes and increased LAFH reportedly associated with a cranially positioned glenoid fossa is observed in UCLP patients also.