Morphologic Analysis of Nasal Airway in 137 Patients With Operated Cleft Lip Nasal Deformity

J Craniofac Surg. 2024 Nov 28. doi: 10.1097/SCS.0000000000010942. Online ahead of print.

Abstract

Objective: The authors aim to clarify the morphology of the nasal airway in patients with cleft lip nose deformities and to analyze the causes of increased nasal resistance.

Methods: One hundred thirty-seven patients with unilateral cleft lip nasal deformities and 30 non-cleft controls were enrolled in this study. These participants were classified into subgroups based on the severity of cleft lip at birth: occult, incomplete, and complete cleft lip. Nasal airway morphologic characteristics were obtained using an acoustic rhinometer, including nasal volume (NV0-2, NV2-7, NV7-11, distance from nostril 0-2, 2-7, 7-11 cm), internal nasal valve area (INVa), and external nasal valve area (ENVa).

Results: When compared with the control group, each group of patients exhibited significantly lower ENVa on the cleft side. However, no significant differences were observed in INVa. The ENVa progressively decreased with the increasing severity of cleft lip, whereas the INVa remained relatively unchanged. Regarding the nasal volume, only the NV0-2 on the cleft side of patients with complete cleft lip showed a significant reduction compared with the control group.

Conclusions: Understanding the morphologic characteristics of the nasal airway in patients with cleft lip nasal deformity can further determine the site of nasal airway stenosis in cleft lip patients. Airway stenosis mainly occurred in the external nasal valve and nasal vestibule regions, whereas the area of the internal nasal valve and the volume of the middle and posterior segments of the nasal airway did not change significantly.