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 (cm²) and volume (cm³) (acoustic rhinometry), air flow resistance (Pa s/cm³) (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.

Key Words::

• Unilateral cleft lip and palate
• cleft size
• acoustic rhinometry
• rhinomanometry
• nasal resistance
• odour identification

Acknowledgements

We thank the Uppsala Cleft Team staff for caring for patients with clefts over the years and for sharing their clinical experiences with us. We thank Lars Berglund, PhD, at the Uppsala Clinical Research, Uppsala, Sweden, for statistical advice and calculations. We thank medical student Caroline Sobocki for retrieving dental models from the archives and for assisting in model measurements. We also thank the patients who participated in the study. This study was made possible by grants from The Uppsala County Council and The Public Dental Health Service, Uppsala County Council.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.