Mastoid pneumatization and aging in children with Pierre-Robin syndrome and in the cleft palate population out of syndrome

Abstract

We examined the characteristics of mastoid pneumatization in the Pierre-Robin syndrome (PRS) and non-PRS cleft palate population in relation to age. There were 14 patients with PRS (median age, 5 years), 7 patients with bilateral cleft lip-palates (BCLP: median age, 6 years), 29 patients with unilateral cleft lip-palates (UCLP: median age, 6 years) and 15 patients with isolated cleft palates (ICP: median age, 7 years). All had secretory otitis and ventilation tubes inserted. Pneumatization was assessed by standard computerized planimetric methods. Temporal bone (Schüller view) X-rays were obtained. Areas of bone pneumatization were outlined and measured separately for each ear. The median pneumatized area of the mastoid (MBP) in PRS patients (6.73 cm²) was significantly lower than in non-PRS cleft patients (7.29 cm²). It was also lower than in UCLP (7.35 cm²; P = 0.01) and ICP (7.19 cm²; P = 0.02). MBP did not change significantly with age in PRS (Spearman r _s = 0.11) and BCLP (Spearman r _s = 0.11), but did increase significantly in the ICP group (Spearman r _s = 0.23; P = 0.04). Cubic regression showed the best fit in the BCLP (r ² = 0.61; P = 0.01) and ICP (r ² = 0.10; P = 0.05). It was not significant for PRS (r ² = 0.132) or UCLP (r ² = 0.049). We concluded that pneumatization in all cases increases with age, but it is statistically significant only in ICP. PRS patients have a lower area of mastoid air-cell size than the non-PRS cleft palate population. The extent of mastoid pneumatization in PRS patients does not correlate with age because of the negative influence of the mandibular hypoplasia and glossoptosis present.