Nasal Airway Dimensions of Adults with Cleft Lip and Palate: Differences among Cleft Types

Abstract

To determine the nasal airway dimensions in adults with repaired cleft lip and palate by rhinomanometry and to analyze the reduction associated with different types of clefts. A prospective analysis comparing three types of previously repaired clefts: bilateral cleft lip and palate (BCLP), unilateral cleft lip and palate (UCLP), and isolated cleft palate (CP) at the 5% level of significance. Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. Fifty-three subjects aged 18 to 35 years (17 BCLP, 16 UCLP, 20 CP) and a group of 20 individuals without cleft (N). Minimum cross-sectional nasal area assessed by posterior (PR) and anterior (AR) rhinomanometry and nasopharyngeal area assessed by modified AR. Mean (+/- 1 SD) nasal areas obtained by PR were: 0.47 +/- 0.16 cm(2) (BCLP), 0.57 +/- 0.19 cm(2) (UCLP), 0.61 +/- 0.13 cm(2) (CP), and 0.60 +/- 0.10 cm(2) (N). The mean value for the BCLP group was significantly smaller than that for the N and CP groups. The remaining values did not differ from one another. The proportion of subjects with subnormal areas obtained by PR was 41%, 19%, and 0% for groups BCLP, UCLP, and CP, respectively. Similar results were obtained by AR. All subjects presented a nasopharyngeal area larger than 0.80 cm(2), denoting absence of obstruction in the nasopharynx. In adulthood BCLP is the type of cleft associated with a greater reduction of nasal airway, compared with UCLP and CP, suggesting that adults with BCLP are at a greater risk for nasal obstruction.