Cause of Sinusitis in Clcft Palate Patients

Abstract

Cleft palate patients often have sinusitis, but the cause of this sinusitis is not known. To clarify the cause of sinusitis in cleft palate patients, we investigated the incidence of sinusitis with regard to the type of cleft, the degree of septal deviation, velopharyngeal function, and presence of a pharyngeal flap. We also examined the laterality of sinusitis in unilateral cleft lip and palate patients. Furthermore, we examined the development of the maxillary sinuses, nasal mucociliary transport by the saccharin method and ciliary beating frequency of ciliated cells taken from the nasal septum in cleft palate patients and normal subjects.
1) The incidence of sinusitis was not related to the type of cleft, the degree of septal deviation, velopharyngeal function, or presence of a pharyngeal flap. In unilateral cleft lip and palate patients, the laterality of sinusitis was not related to the cleft side. Therefore, we considered that contamination of the nasal cavity through the cleft and incompetent velopharynx were not cause of sinusitis; neither was the stagnation of nasal secretion in the presence of a pharyngeal flap nor obstruction of the maxillary ostium by a middle turbinate secondary to a deviated septum.
2) There was no difference in the size of the maxillary sinus between the control group and the cleft group. Therefore, underdevelopment of the maxillary sinus did not appear to be a cause of sinusitis in cleft palate patients.
3) Nasal mucociliary transport was impaired in cleft palate patients, and this impairment was thought to be a cause of the high incidence of sinusitis in cleft palate patients.
The frequency of ciliary beating was lower in the cleft group than in the control group, but further investigation is necessary to determine whether the lowered ciliary beating frequency is a factor in the impairment of nasal mucociliary transport.