先天性鼻咽腔閉鎖不全症の鼻副鼻腔疾患 口蓋裂例との比較

Abstract

Congenital velopharyngeal insufficiency (CVPI) is characterized by a disorder of the velopharynx similar to that observed in cleft palate without an overt or submucous cleft. We investigated nasal disease in 62 patients with congenital velopharyngeal insufficiency and compared the findings with those in cleft palate patients and normal subjects.The incidence of sinusitis in CVPI patients (46.8%) was similar to that in cleft palate patients (44.4%)-markedly higher than in normal subjects (<10%). The incidence of septal deviation was low (25.8%), and total nasal resistance was almost normal in CVPI patients. In contrast, in patients with cleft palate, septal deviation was common, and total nasal resistance was significantly higher than that in CVPI. The saccharin test was performed to evaluate nasal mucociliary clearance, and the ciliary beating frequency (CBF) of ciliated cells from the septal mucosa was also examined, since nasal mucociliary dysfunction was assumed to be one of the causes of sinusitis in cleft palate patients. In CVPI patients, the saccharin time and CBF values were normal. Further investigation is needed to evaluate the cause of the high incidence of nasal sinusitis in patients with CVPI.