Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. V. A postoperative evaluation of nasal patency.

The nasal patency of children born with complete unilateral or bilateral cleft lip and palate was studied with rhinomanometry. The children had all been early bone grafted with a "four-flap" technique. The unilateral deformities were composed of two groups. One group of 39 children (mean age 17.6 years) primarily operated without preoperative orthopedics and another group of 46 children (mean age 10.8 years), where preoperative orthopedics ("T-traction") was performed before the operation. In the bilateral group, 19 children (mean age 15.1 years), preoperative retropositioning pressure and if necessary outward rotation of the lateral maxillary segments was performed before the operation. No difference of total nasal patency was found between unilateral and bilateral cleft children. The nasal cavity of the cleft side of unilateral clefts had, however, a more pronounced nasal stenosis than each cavity of bilateral clefts. In unilateral groups a significant difference in nasal patency was found between the cleft and the noncleft side. This difference was not changed by decongestion indicating a skeletal anatomical stenosis. Nasal patency did not differ between the unilateral groups. However, considering the age difference between the two groups a further improvement of nasal patency with increasing age may possibly occur in the younger "T-traction" group.