Nasal airway dimensions of adults with cleft lip and palate: Differences among cleft types

Objective: 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. Model: 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. Setting: Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil. Participants: Fifty-three subjects aged 18 to 35 years (17 BCLP, 16 UCLP, 20 CP) and a group of 20 individuals without cleft (N). Variables: Minimum cross-sectional nasal area assessed by posterior (PR) and anterior (AR) rhinomanometry and nasopharyngeal area assessed by modified AR. Results: 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. Conclusions: 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.