Dimensions of the Cleft Nasal Airway in Adults: A Comparison With Subjects Without Cleft

Abstract

The prevalence of mouthbreathing among individuals with cleft lip and palate is significantly higher than in the normal population. This has been attributed to nasal deformities that tend to reduce nasal airway size. The purpose of the present study was to determine how a heterogeneous adult group with cleft lip and palate differs in terms of nasal airway cross-sectional area from an adult. group without cleft during the inspiratory and expiratory phases of breathing. The pressure-flow technique was used to estimate nasal airway size in 15 adults without cleft (15 years or older) and 37 adults with cleft lip, cleft palate, or both. Mean areas and standard deviations for subjects without cleft were 0.63 cm2 i 0.17 during inspiration and 0.56 cm2 i 0.14 during expiration. This difference is statistically significant (p < 0.01). Mean areas and standard deviations for all subjects with cleft were 0.37 cm2 i 0.18 during inspiration and 0.40 cm2 i 0.20 during expiration. This difference is not statistically significant (p > 0.15). Twenty-two of the subjects with cleft had nasal areas considered to be impaired (below 0.40 cm2) as compared with only three of the subjects without cleft. A two factor analysis of variance (ANOVA) demonstrated that area changes during respiration are different for subjects with and without cleft (p < 0.005), and that cleft nasal areas are smaller than noncleft areas for both phases of breathing (p < 0.001). lnspiratory—expiratory differences between subjects with and without cleft are probably the result of developmental defects , reparative surgery or both. The findings from this study confirm the presence of impairment in a significant proportion of the cleft population and suggest that physiologic responses to impairment may be different.