Results of a prospective anthropometric and functional study about aesthetics and nasal respiration after secondary rhinoplasty in cleft lip and palate patients.

In contrast to the multitude of investigations regarding aesthetic changes in nasal surgery, few data are available concerning nasal function. This is especially important for cleft patients with a compromised nasal respiration.In this prospective study, 68 cleft patients, who underwent nasal surgery, were evaluated concerning aesthetic and respiratory outcome. To assess nasal respiration, active anterior rhinomanometry, rhinoresistometry, and acoustic rhinometry were performed preoperatively and 6 months postoperatively (without and with nasal decongestion, according to international standards). For analyzing the changes in aesthetic parameters, photographs from 3 directions, which were taken preoperatively and at least 6 months postoperatively, were compared. Thus, 57 angles and relations of lines were created out of 54 anthropometric points. The Wilcoxon test was used to compare preoperative and postoperative data (P < 0.05). Regarding aesthetic outcome, a significant improvement in many parameters was seen. The noses postoperatively proved to be significantly narrower and more symmetric and showed a better projection.Although analysis of functional respiratory data showed a significant increase in nasal volume, no change in nasal airflow and hydraulic diameter could be found.Whereas aesthetic improvement of the cleft nose is a goal, which can be achieved regularly, nasal respiration still seems to be a challenge in cleft patients. This study highlights the necessity of taking functional data to learn more about the effects of surgery. Objective methods to assess nasal respiratory function are important for planning and performing nasal surgery and are a means of quality control.