口蓋裂例の鼻副鼻腔疾患 文献的考察

Abstract

It has been reported that cleft palate patients have a high incidence of nasal and paranasal diseases. Several problems remain to be solved.We surveyed the literature and correlated nasal diseases in cleft palate patients with intranasal deformities, development of maxillary sinuses, nasal sinusitis and nasal function.1) In patients with unilateral cleft lip and palate, intranasal deformities have been investigated by tomography and CT scan. They have not been reported in other types of cleft palate.Maxillary sinus development has been studied by frontal and lateral x-ray films. Recent reports have shown normal development of the maxillary sinus in patients with cleft palate. In the future, it will be necessary to investigate the intranasal deformities and parana.sal sinus development with three dimensional computer reconstruction.2) The incidence and features of nasal sinusitis in cleft palate patients have been clarified t o some extent. However, it is not known whether nasal allergy contributes to sinusitis in these patients.Impairment of nasal mucociliary transport is thought to be one of the reasons for the high incidence of sinusitis in cleft palate patients. It is necessary to study the mucociliary system by electron microscopy.3) Nasal airway patency has been studied by rhinomanometry, and all reports except one showed high nasal airway resistance in cleft palate patients. It was noted that several factors, such as deviation of the nasal septum, mucosal thickening and hypertrophy of the inferior turbinate raised nasal airway resistance.Surgical treatment of intranasal deformities is thought to be necessary because high nasal airway resistance may impair nasal mucociliary function.