To evaluate the nasal patency using acoustic rhinometry (AR) in patients with unilateral cleft lip and palate (UCLP) and to ascertain the rhinological importance of the same.
Methods:
Eccovision Acoustic Rhinometer system was used for assessment of nasal cross-sectional area (CSA) and volume in 15 patients with UCLP. The CSA1, CSA2, and CSA3, which represent the CSA at the nasal valve area and anterior end of the inferior turbinate, the anterior half of the inferior turbinate and the anterior end of the middle turbinate, and the region of middle portion of middle turbinate, respectively, were compared on the cleft and non-cleft side.
Results:
The mean ± SD of CSA1, CSA2, and CSA3 as well as the overall nasal CSA were significantly higher on non-cleft side compared to cleft side (P value < .001). The mean ± SD of nasal volume was also significantly higher in non-cleft side compared to cleft side (P value < .001).
Conclusions:
The nasal patency among patients with UCLP demonstrates a range of impairments that can be objectively measured using acoustic rhinometry. The orthodontic, orthopedic, or orthosurgical management of maxillary deficiency in these patients can affect the nasal area and volume and can have an impact on breathing, speech, and sleep. The pretreatment assessment may be useful to identify patients who are at potential risk of deterioration of nasal patency and airway post-intervention. Taking into consideration the multiple diagnostic procedures in the course of long-term multidisciplinary treatment of patients with cleft lip and palate, a noninvasive investigation technique such as AR may be the preferred mode of investigation to ascertain nasal patency.
AndreRFVuykHDAhmedAGraamansKNolst TreniteGJ. Correlation between subjective and objective evaluation of the nasal airway: a systematic review of the highest level of evidence. Clin Otolaryngol. 2009;34(6):518–525.
2.
CakmakOTarhanECoskunMCankurtaranMCelikH. Acoustic rhinometry: accuracy and ability to detect changes in passage area at different locations in the nasal cavity. Ann Otol Rhinol Laryngol. 2005;114(12):949–957.
3.
CankurtaranMCelikHCoskunMHizalECakmakO. Acoustic rhinometry in healthy humans: accuracy of area estimates and ability to quantify certain anatomic structures in the nasal cavity. Ann Otol Rhinol Laryngol. 2007;116(12):906–916.
4.
CheungEJCitardiMJFakhriSCainJBatraPSLuongA. Comparison of optical rhinometry to acoustic rhinometry using nasal provocation testing dermatophagoides farinae. Otolaryngol Head Neck Surg. 2010;143(2):290–293.
5.
CoreyJPGungorANelsonRFredbergJLaiV. A comparison of the nasal cross-sectional areas and volumes obtained with acoustic rhinometry and magnetic resonance imaging. Otolaryngol Head Neck Surg. 1997;117(4):349–354.
6.
DalstonRMWarrenDDalstonET. A preliminary study of nasal airway patency and its potential effect on speech performance. Cleft Palate Craniofac J. 1992:29(4):330–335.
7.
DastidarPNumminenJHeinonenTRyyminPRautiainenMLaasonenE. Nasal airway volumetric measurement using segmented HRCT images and acoustic rhinometry. Am J of Rhinol. 1999;13(2):97–103.
8.
DemirbasDCingiCÇakliHKayaE. Use of rhinomanometry in common rhinologic disorders. Expert Rev Med Devices. 2011;8(6):769–777.
9.
DrakeAFDavisJUWarrenDW. Nasal airway size in cleft and noncleft children. Laryngoscope. 1993;103(8):915–917.
10.
GigerRPaschePCheseauxCCantiniLRossettiALandisBNLacroixJS. Comparison of once-versus twice daily use of beclomethasone dipropionate aqueous nasal spray in the treatment of allergic and non allergic chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2003;260(3):135–140.
11.
GilainLCosteARicolfiFDahanEMarliacD. Nasal cavity geometry measured by acoustic rhinometry and computed tomography. Arch Otolaryngol Head Neck Surg. 1997;123(4): 401–405.
12.
GomesATeixeiraASTrindadeSTrindadeI. Nasal cavity geometry of healthy adults assessed using acoustic rhinometry. Rev Bras Otorrinolaringol. 2008;74(5):746–754.
13.
GrossmannNBrinIAizenbudDSichelJYIsseroffRGSteinerJ. Nasal airflow and olfactory function after the repair of cleft palate (with and without cleft lip). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(5):539–544.
14.
GrymerLFHilbergOElbrondOPedersenOF. Acoustic rhinometry: evaluation of the nasal cavity with septal deviations, before and after septoplasty. Laryngoscope. 1989;99(11):1180–1187.
15.
GrymerLFHilbergOPedersenOFRasmussenTR. Acoustic rhinometry: values from adults with subjective normal nasal patency. Rhinology. 1991;29(1):35–47.
16.
HilbergOJacksonACSwiftDLPedersenOF. Acoustic rhinometry: evaluation of nasal cavity geometry by acoustic reflection. J Appl Physiol. 1989;66(1):295–303.
17.
HilbergOJensenFTPedersenOF. Nasal airway geometry: comparison between acoustic reflections and magnetic resonance scanning. J Appl Physiol. 1993;75(6):2811–2819.
18.
HilbergOPedersenOF. Acoustic rhinometry: recommendations for technical specifications and standard operating procedures. Rhinol Suppl. 2000;16:3–11.
19.
Hocevar-BoltezarIJarcAKozeljV. Ear, nose, and voice problems in children with orofacial clefts. J Laryngol Otol. 2006;120(4):276–281.
20.
HopkinsC.Re: correlation between subjective and objective evaluation of the nasal airway. Clin Otolaryngol. 2010;35(2):147–148.
21.
HouserSMMamikogluBAquinoBFMoinuddinRCoreyJP. Acoustic rhinometry findings in patients with mild sleep apnea. Otolaryngol Head Neck Surg. 2002;126(5):475–480.
22.
KemkerBLiuXGungorAMoinuddinRCoreyJP. Effect of nasal surgery on the nasal cavity as determined by acoustic rhinometry. Otolaryngol Head Neck Surg. 1999;121(5):567–571.
23.
KunkelMWahlmannUWagnerW. Acoustic airway profiles in unilateral cleft palate patients. Cleft Palate Craniofac J. 1999;36(5):434–440.
24.
LalDCoreyJP. Acoustic rhinometry and its uses in rhinology and diagnosis of nasal obstruction. Facial Plast Surg Clin N Am. 2004;12(4):397–405.
25.
LendersHPirsigW.Diagnostic value of acoustic rhinometry: patients with allergic and vasomotor rhinitis compared with normal controls. Rhinology. 1990;28(1):5–16.
26.
LendersHSehollRBrunnerM. Akustische Rhinometrie: das Fledermausprinzip in der. Nase. 1992;40(7):239–247.
27.
LuegEAIrishJCRothYBrownDHWitterickIJChapnickJSGullanePJ. An objective analysis of the impact of lateral rhinotomy and medial maxillectomy on nasal airway function. Laryngoscope. 1998;108(9):1320–1324.
28.
MamikogluBHouserSAkbarINgBCoreyJP. Acoustic rhinometry and computed tomography scans for the diagnosis of nasal septal deviation, with clinical correlation. Otolaryngol Head Neck Surg. 2000;123(1):61–68.
29.
MinYGJangYJ. Measurements of cross-sectional area of the nasal cavity by acoustic rhinometry and CT-scanning. Laryngoscope. 1995;105(7):757–759.
30.
MochidaMOnoKSaitoSTsuikiKOhyamaK. Effects of maxillary distraction osteogenesis on the upper-airway size and nasal resistance in subjects with cleft lip and palate. Orthod Craniofac Res. 2004;7(4):189–197.
31.
MorenSManiMLundbergKHolmstromM. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate. J Plast Surg Hand Surg. 2013;47(5):383–389.
32.
Munoz-CanoRSalvadorRValeroABerenguerJAlobidIBartraJGuilemanyJMMullolJPicadoC. Accuracy of acoustic rhinometry versus computed tomography in evaluation of nasal cavity in patients with nasal polyposis. Rhinology. 2010;48(2):224–227.
33.
NanciLDe FelippeNeetaBAdrianaCGraceVBonnieS. Long-term effects of orthodontic therapy on the maxillary dental arch and nasal cavity. Am J Orthod Dentofacial Orthop. 2009;136(4):490.e1–8.
34.
NigroCENigroJFVoegelsRLMionOMelloJFJr. Acoustic rhinometry: anatomic correlation of the first two notches found in the nasal echogram. Rev Bras Otorrinolaringol. 2005;71(2):149–154.
35.
OuriquesDMCarliniDFujitaRPignatariSSWeckxLL. Correlation between fiberoptic nasal endoscopy and acoustic rhinometry in adults without nasal complaints. Am J Rhinol. 2006;20(4):375–378.
36.
RaspJR.Akustische rhinometrie: messung in der fdih- und Sp∼itphase der allergischen Sofortreaktion bei der allergischen Rhinitis. Laryngo Rhino Otol. 1993;72:125–130.
37.
SaitoKOnoTMochidaMOhyamaK. Changes in nasorespiratory function in association with maxillary distraction osteogenesis in subjects with cleft lip and palate. Cleft Palate J. 2006;43(1):75–83.
38.
SuriSUtrejaAKhandelwalNMagoSK. Craniofacial computerized tomography analysis of the mid face of patients with repaired complete unilateral cleft lip and palate. Am J Orthod Dentofac Orthop. 2008;134(3):418–429.
39.
TavernerDDanzCEconomosD. The effects of oral pseudoephedrine on nasal patency in the common cold: a double blind single-dose placebo-controlled trial. Clin Otolaryngol. 1999;24(1):47–51.
WangZWangPZhangYShenG. Nasal airway evaluation after le fort i osteotomy combined with septoplasty in patients with cleft lip and palate. J Craniofac Surg. 2017;28(1):207–211.
42.
WarrenDWHairfieldWMDalstonETSidmanJDPillsburyHC. Effects of cleft lip and palate on the nasal airway in children. Arch Otolaryngol Head Neck Surg. 1988;114(9):987–992.
43.
WarrenDW. A quantitative technique for assessing nasal airway impairment. Am J Orthod. 1984;86(4):306–314.
44.
WarrenDWDrakeAF. Cleft nose, form and function. Clin Plast. Surg. 1993;20(4):769–779.
