Rhinomanometry in patients with a cleft deformity of the nose

A typical cleft deformity of the central facial area is very frequently associated with impaired patency of the nose. Rhinomanometry makes it possible to assess objectively and quantitatively the patency of these airways. For objective assessment of the disorder this examination was made closely before secondary rhinoplasty in 36 patients with complete unilateral (81%) or bilateral cleft (19%). Using the method of active anterior rhinomanometry, values of nasal flow and nasal resistance were assessed. Subsequently the degree of obstruction of the nasal airways and the lateral ratio of the nasal flow were evaluated. The mean value of the total nasal flow was 239.9 cm3/s, and the mean value of nasal resistance for individual nasal vents was 3.55. The results were compared with normal values according to Bachmann. It was revealed that patients with clefts suffer in 88% of casesfrom significant obstruction of the nasal airways and In the remaining 12% of cases from mild obstruction. The lateral ratio can be evaluated as normal only in 19% and 14% of patients with unilateral and bilateral clefts respectively. Although the great majority of patients ask for secondary correction because they want to improve their appearance, It is an advantage to express objectively the functional disorder of nasal patency before surgery--thus defining the indication more accurately--and to explain to the patient the possible benefit of the operation.