Initial size of cleft does not correlate with size and function of nasal airway in adults with unilateral cleft lip and palate

Abstract

The noses of patients with clefts are often functionally inadequate. The aim of the present study was to evaluate the correlation between size of the maxillary cleft in infancy and size and function of the nasal airway in adults with unilateral cleft lip and palate (UCLP). This is a long-term follow up study including 53 patients with UCLP born between 1960 and 1987 and treated at the Cleft Lip and Palate Centre, Uppsala University Hospital, Sweden. Lip repair was performed at 3-4 months of age followed by either a one-stage or a two-stage palatal closure. The size of the cleft was measured on infant maxillary dental casts. Nasal minimum cross-sectional area (cm(2)) and volume (cm(3)) (acoustic rhinometry), air flow resistance (Pa s/cm(3)) (rhinomanometry), peak inspiratory flow (l/min) (peak nasal inspiratory flow) and number of identified odours (Scandinavian odor-identification test) were assessed in adulthood. The size of the maxillary cleft varied considerably at infancy. The size of the nasal airway and its function on the cleft side in adulthood were reduced compared with the non-cleft side, but no correlations were found between size of the initial cleft in infancy and size and function of the nasal airway in adulthood. In adults born with UCLP, therefore, size of the maxillary cleft in infancy does not seem to affect size and function of the nasal airway in adulthood.

Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared With Skeletal Class III Individuals

“…The extent of abnormal midface growth varies from mild to severe (Shetye, 2016). Nasal deformities are quite common in patients with CLP and affect the size of the nasal cavity and nasal respiration (Reiser et al, 2011). Trindade et al (2015) evaluated the nasal airways of children with UCLP using acoustic rhinometry and showed that the UCLP children had narrower nasal cross-sectional areas than the noncleft children.…”

“…The extent of abnormal midface growth varies from mild to severe (Shetye, 2016). Nasal deformities are quite common in patients with CLP and affect the size of the nasal cavity and nasal respiration (Reiser et al, 2011).…”

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate

“…An association between the severity of the cleft and the degree of the nasal septum deviation has been found in patients with UCLP examined by CT [5]. However, Reiser et al [6] found no correlation between initial cleft size and nasal airway size and airflow in patients treated for UCLP.…”

Nasal Airway Dimensions of Children with Repaired Unilateral Cleft Lip and Palate

“…Acoustic rhinometry has been extensively used in the general adult and pediatric population to objectively assess nasal patency. A few studies have used the technique to assess nasal obstruction in adults with cleft lip and palate, demonstrating a wide range of impairment, mostly on the affected side (Kunkel et al, 1997(Kunkel et al, , 1999Huempfner-Hierl et al, 2009;Trindade et al, 2009;Mani et al, 2010;Reiser et al, 2011). However, findings on adults are not applicable to children because nasal airflow resistance changes with age (Saito and Nishihata, 1981).…”