[Functional and aesthetic outcome of nasal surgery in cleft lip palate patients]

Between June 1996 and November 2000 60 patients suffering from severe nasal dysplasia due to cleft lip and palate (CLP) underwent corrective nasal surgery. Diagnoses included 37 cases of unilateral CLP and 23 cases of bilateral CLP. Age ranged from 7 to 50 years. To assess functional outcome three different methods were used pre- and postoperatively with and without nasal decongestion: active anterior rhinomanometry, rhinoresistometry, and acoustic rhinometry. For the measurement of esthetic changes frontal, lateral, and caudal photographs were analyzed. Compared to a non-cleft population esthetic and functional impairment was evident preoperatively. Postoperatively a statistically significant improvement in nasal projection and configuration was seen. Concerning nasal respiration an improvement in nasal flow and hydraulic diameter was noted in the unilateral CLP group only, whereas a statistically nonsignificant average deterioration was found in the bilateral CLP group. No correlation existed between external nasal form or the change in nasal appearance and nasal function. Whereas the esthetic outcome of nasal surgery is covered by way of photo-analysis in many centers, a distinct lack of measuring the effects on nasal function can be stated. Without using objective methods, however, no data for improving surgical procedures and for internal quality control are at hand.