الفهرس 
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Abstract
It was done to evaluate pharyngeal airway space changes in cleft patient and control non cleft patient.
The sample included 60 patients control and cleft groups, ranging from 8-12 years.
The patients divided into 2 groups:
A) First group (control non-cleft group) included 30 patients’ CBCT (21 males and 9 females) with (Class I : 12 cases, Class II: 16 cases, Class III: 2 cases ).
B) Second group (cleft group) included 30 patients’ CBCT (18 males and 12 females) with (Class I: 2 cases, Class II: 5 cases and Class III: 23 cases).
A Cone Beam Computed Tomography (CBCT) radiographs used to evaluate pharyngeal airway space (oropharyngeal and nasopharyngeal) airway (width, depth and volume).
Linear Measurement:
A) Oropharynx (width and Depth):
1-After importing the images, section view were selected where axial, coronal and sagittal views are displayed
2- At the sagittal view; volume was reoriented by reorientation tool provided by the software in order to adjust the axial reference line to be parallel to the Frankfurt plane (Orbitale-Porion)
3-After previous adjustment, axial reference line was moved to intersect with Gonion at the coronal and sagittal views. At the produced axial .
Image Oro-pharyngeal space was measured in two direction; width (mediolateral aspect), and depth (antero-posterior aspect).
B )Nasopharynx (width and Depth):
1-At the sagittal view, the volume was reoriented in such a way to align the axial reference line with the porion and first molars intercuspation at the right side.
2- At the produced axial view, nasopharyngeal dimensions were calculated in the same manner as in oropharynx width and depth.
C) Volumetric analysis ( oropharynx and nasopharynx):
1-All patients’ (cleft and control) CBCT images were submitted to another software for volume measurement.
2- Mimics software was used for volume calculation.
3-After importing the DICOM files into the software, a fixed threshold was assigned to create the desired mask were the assigned threshold corresponded to the density of airway.
4- A targeted airway section was isolated by removing any unnecessary structures.
5-The threshold value was established in a range from (-1,024 to -300) according to
Kyung-Min Oh et al, 201365.
6- After thresholding cropping and region growing was adjusted to define the outlines of the oropharynx and nasopharynx.
The anterior limit of the nasopharyngeal space was defined by the coronal plane perpendicular to the FH plane and sagittal plane that passes through PNS. Oro pharyngeal space was defined as the airway space between the planes passing through PNS and the epiglottis base. After defining the outline of oropharynx and nasopharynx, a separate mask was created for each one and its volume was automatically acquired.
The following conclusions can be drawn from the current study:
1- Oropharyngeal airway space (depth-width) significantly decreased in cleft than control patient.
2- There was no significant different in oropharyngeal and nasopharyngeal in male cases.
3- There was significant deferent in oropharyngeal (width ,depth , volume )and nasopharyngeal( width).
4- There was significantly different in the CLP group compared to control group in male and female at age≤9 years in nasopharyngeal airway(width-volume).
5- There was no significant different in the CLP group compared to control group in male and female at age(10-11) years.
6- There was significant Differences between the control and cleft groups at age (12 ) years in the oropharyngeal (depth ,volume).
7- There was significant Different in skeletal classes affect on pharyngeal airway (orophayngeal-nasopharyngeal).
The following recommendation can be drawn from this study :
Any orthodontic or orthognatic interventions to treat Class III skeletal pattern of cleft patient should include advancement of the maxilla to increased oropharyngeal airway space.
Suggestions for further investigations:
1-Sample selection should be same age, sex and same skeletal.
2-Age selection for male group should be after 12 years of age.