Ultrasound antenatal diagnosis of cleft palate by a new technique: the 3D ‘reverse face’ view

TLDR

Existing antenatal ultrasound techniques reliably detect lip and alveolar ridge clefts but fail to visualize the fetal palate accurately. The study aimed to evaluate the clinical utility of a novel three‑dimensional reverse‑face (3D RF) ultrasound view for antenatal classification of facial clefts, especially hard palate involvement. Eight fetuses with suspected clefts were examined using 3D surface rendering, with the face rotated 180° on the vertical axis to generate the reverse‑face view of the secondary palate. The 3D RF view enabled visualization of the fetal palate in all cases, with antenatal diagnoses confirmed post‑natally, achieving high accuracy, though a soft‑palate cleft was missed in one left‑sided lip cleft case. © 2004 ISUOG; published by John Wiley & Sons, Ltd.

Abstract

Abstract Objective To assess the clinical value of a novel three‐dimensional (3D) ultrasound technique, the reverse face view (3D RF view), in the antenatal categorization of facial clefting and in particular clefting of the hard palate. Methods Eight cases of suspected orofacial clefting were examined by 3D surface rendering. The fetal lips and alveolar ridge were examined in the frontal plane and the face was then rotated through 180° on the vertical axis to examine the secondary palate by the 3D RF view. Results In each case described, we were able to visualize the fetal face, lips and palate and make an antenatal diagnosis as to whether the palate was affected. In all cases, the antenatal diagnosis was subsequently confirmed. In one case with a left‐sided cleft in the lips and alveolar ridge and an intact hard palate, the correct diagnosis was made but a cleft in the soft palate was missed. Conclusion Although clefts of the lips and alveolar ridge are readily diagnosed on high‐quality antenatal ultrasound, visualization of the fetal palate using existing techniques is unreliable. In the patients described here, the 3D RF technique allowed relatively straightforward assessment of the fetal palate with a high degree of accuracy. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.