Nasal and paranasal sinus disease in patients with congenital velopharyngeal insufficiency

To investigate nasal and paranasal disease in patients with congenital velopharyngeal insufficiency (CVPI).

Case series.

Patients with CVPI or cleft palate were investigated at Kyoto (Japan) University Hospital.

Consecutive sample (60 patients with CVPI and 333 with cleft palate). No eligibility criteria or sociodemographic features. Random sample (normal subjects).

The incidence of sinusitis and septal deviation, nasal airway resistance, nasal mucociliary function by saccharin test, and ciliary beating frequency were examined. These findings in patients with cleft palate and normal subjects were compared to clarify the features of nasal disease in CVPI.

The incidence of sinusitis in CVPI was 46.7% and approximately equal to that in cleft palate (44.1%). The incidence of septal deviation in CVPI (26.7%) was low and nasal airway resistance was almost normal. In contrast, in patients with bilateral, unilateral, or incomplete cleft palate, the incidence of septal deviation was significantly more frequent (78.9%) than that in CVPI (P < 0.001), and nasal airway resistance was significantly higher than that in CVPI (P < .0001). In patients with submucosal cleft, septal deviation was found in 40.8% and nasal airway resistance was significantly higher than that in CVPI (P < .02). Although saccharin time was significantly prolonged (P < .001) and ciliary beating frequency was significantly lower (P < .005) in patients with cleft palate than in normal subjects, values for these tests in patients with CVPI were normal.

The incidence of sinusitis was high in CVPI. However, the frequency of septal deviation and nasal airway resistance was almost normal. Nasal mucociliary function (saccharin time and ciliary beating frequency) was also normal.