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While early radiological signs of nasopharyngeal carcinoma often present as an asymmetric obliteration of the Rosenm\u00fcller fossa (RF), the impact of congenital CLP-related variations on this clinical detection remains a subject of debate with no definitive consensus. This study investigates these hypotheses by evaluating nasopharyngeal structural remodeling using cone-beam computed tomography (CBCT). To determine whether the morphometric changes are local or regional, unilateral (cleft\/non-cleft sides), bilateral, and healthy individuals were compared. Based on our measurements, results indicate a specific structural transformation in the CLP nasopharynx characterized as a \u2018narrow and long\u2019 configuration, with both sides similarly affected even in unilateral cases. These findings suggest that CLP should be viewed not merely as a localized anatomical defect, but rather as a regional morphometric remodeling involving the entire nasopharyngeal complex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed CBCT images of 78 CLP and 78 healthy individuals. Parameters included RF depth and type, torus levatorius (TL) length, inter-torus distance (ITD), posterior nasal spine - posterior pharyngeal wall distance (PNS-PPW), eustachian tube length (ETL), ET angle (ETA), tympanotubal angle (TTA), and pharyngeal bursa (PB) presence. Subjects were categorized as unilateral (cleft\/non-cleft sides), bilateral, or control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      RF morphological types varied significantly between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), although RF depth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.155) and PB presence showed no significant differences. CLP groups exhibited significantly higher TTA and TL length (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and increased PNS-PPW distance, particularly in bilateral cases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Conversely, ETL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) and ITD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) were significantly higher in controls. ETA showed no significant difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CLP appears to be associated with morphometric remodeling of the nasopharynx and the eustachian tube, which is more pronounced in bilateral cases. These structural abnormalities may provide a potential framework for assessing velopharyngeal dysfunction and middle ear pathologies in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08976-2","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T01:56:26Z","timestamp":1781920586000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Rosenm\u00fcller fossa depth and nasopharyngeal structures in individuals with cleft lip and palate using cone-beam computed tomography"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9997-0987","authenticated-orcid":false,"given":"Merva","family":"G\u00fcneyli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0798-9355","authenticated-orcid":false,"given":"Emin Murat","family":"Canger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"8976_CR1","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.3390\/genes14081603","volume":"14","author":"A Babai","year":"2023","unstructured":"Babai A, Irving M. 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Ethical approval was granted by the Erciyes University Health Sciences Ethics Committee (Decision Date: 2025, No: 370). Since the study involved a retrospective analysis of existing anonymized radiographic data (CBCT) and clinical records obtained from the institutional archive, the requirement for informed consent was officially waived by the Health Sciences Ethics Committee of Erciyes University. This waiver specifically applies to all participants, including those under the age of 16 (minors), as the research posed no risk to the participants and involved no direct contact.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1838"}}