PREMAXILLARY PROTRUSION - A SONOGRAPHIC CLUE TO BILATERAL CLEFT-LIP AND PALATE

Sonograms from 49 fetuses with cleft lip, with or without cleft palate , were reviewed. Among 37 fetuses with adequate pathologic or clinical correlation, 10 (27%) demonstrated premaxillary protrusion, seen as a paranasal echogenic mass. Nine of ten fetuses with a paranasal echoge nic mass proved to have bilateral cleft lip and cleft palate. Converse ly, only two of 27 fetuses who did not show a paranasal echogenic mass proved to have bilateral cleft lip and cleft palate, and neither of t hese fetuses showed premaxillary protrusion at birth. Sonographic eval uation of the cleft alone erroneously misclassified eight fetuses with bilateral cleft lip and cleft palate as having unilateral clefts. Pre maxillary protrusion is an important due to the presence of cleft lip and cleft palate and may be more conspicuous than the cleft itself. Fu rthermore, the presence of a paranasal echogenic mass favors the prese nce of bilateral cleft lip and cleft palate, even when sonographic eva luation of the cleft itself suggests a unilateral cleft. This informat ion should be useful in the detection and management of fetUses with s uspected facial clefts.