Acoustic Rhinometry in Cleft Lip-Palate Children with Transverse Maxillary Deficiency

Objective: Acoustic rhinometry provides information about cross-sectional areas and volumes of different segments of the nasal cavity, allowing the analysis of the impact of therapeutic procedures, such as rapid maxillary expansion (RME), on nasal airway size. The purpose of this prospective study was to delineate nasal geometry of children with cleft lip and palate (CLP) requiring RME, as compared to children without cleft, by means of acoustic rhinometry. Methods: Ten children with repaired unilateral (n=4) and bilateral (n=6) CLP presenting transverse maxillary deficiency (TMD), aged 8 to 10 years, and 10 healthy controls without cleft, of both genders, aged 8 to 9 years, were evaluated. Cross-sectional areas measured at the 2nd, 3rd and 4th notches in the rhinogram (CSA1, CSA2 and CSA3), and volumes measured at 1-3.2cm (V1) and 3.3-6.4cm (V2) from the nostril were determined with an Eccovision Acoustic Rhinometer-Hood Laboratories, before and after nasal decongestion (ND). For comparison purposes, values of the right and left sides of the nasal cavity were added. Differences were considered to be significant when p<0.05. Results: For the cleft group, mean values (±SD) of CSA1, CSA2, CSA3 (in cm2), V1 and V2 (in cm3), were: 0.63(0.15), 1.32(0.42), 2.00(0.69), 1.91(0.46) and 5.08(1.62), respectively. Control values corresponded to 0.66(0.16), 1.27(0.38), 1.81(0.64), 1.95(0.46) and 5.10(1.57), respectively. Differences between groups were not statistically significant. Similar results were seen after ND. Preliminary data obtained in one cleft patient showed that RME yielded a marked increase of CSA and V mean values. Conclusion: Results suggest that, differently from adults, children with CLP(TMD) may not have significant impairment of nasal patency. Variables not-controlled for the cleft group, such as previous surgeries, type and severity of malocclusion, and type and extension of cleft may explain the findings.

Financial support: FAPESP-2007/03294-4, Brazil