Cone-Beam Computed Tomography Incidental Findings in Individuals With Cleft Lip and Palate

Giancarlo Santos, Ilana Ickow, Joici Job, Jack E. Brooker, Lucas A. Dvoracek, Erick Rigby, Nilesh Shah, Wendy Chen, Barton Branstetter, Lindsay A. Schuster

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: The use of cone-beam computed tomography (CBCT) is well-established in clinical practice. This study seeks to categorize and quantify the incidental finding (IF) rate on CBCT in patients with cleft lip and palate (CLP) prior to orthodontic or surgical treatment. Methods: This is systematic retrospective review of head and neck CBCTs in patients with nonsyndromic CLP taken between 2012 and 2019 at a single tertiary referral center. All assessments were performed independently by 4 observers (a head and neck radiologist and 3 orthodontists, including 2 fellowship-trained cleft-craniofacial orthodontists). The images were divided into 9 anatomical areas and screened using serial axial slices and 3D reconstructions. The absolute number of IFs was reported for each area and statistical analysis was performed. Results: Incidental findings were found in 106 (95.5%) of the 111 patients. The most common sites were the maxilla (87.4%, principally dental anomalies), paranasal sinuses (46.8%, principally inflammatory opacification), and inner ear cavities (18.9%, principally inflammatory opacification). Eleven patients had skull malformations. Thirty-three patients had IFs in 1 anatomical area, 49 patients in 2 anatomical areas, 19 patients in 3 areas, and 5 patients presented with IFs in 4 of the 9 anatomical areas. Discussion: In patients with CLP, IFs on CBCT exam were present in the majority of cases. Most patients with IFs had them in multiple anatomical areas of the head and neck. The maxillary dental–alveolar complex was the most common area. Inflammatory changes in the inner ear cavities and paranasal sinuses were also common; however, cervical spine and skull abnormalities were also identified. Clinicians caring for patients with CLP should be aware of IFs, which may warrant further investigation and treatment.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalCleft Palate-Craniofacial Journal
Issue number4
StatePublished - Apr 1 2020


  • anatomy
  • cone-beam computed tomography
  • dental anomalies
  • dysmorphology
  • incidental findings
  • nonsyndromic clefting

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology


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