1. Nasal Obstruction in Children With Cleft Lip and Palate: Results of a Cross-Sectional Study Utilizing the NOSE Scale.
- Author
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Zhang, Rosaline S., Lin, Lawrence O., Hoppe, Ian C., Jackson, Oksana A., Low, David W., Bartlett, Scott P., Swanson, Jordan W., and Taylor, Jesse A.
- Subjects
RESPIRATORY obstructions ,NOSE ,ALVEOLAR process ,THORACIC surgery ,CHILDREN'S hospitals ,CLEFT lip ,CLEFT palate ,SURGICAL flaps ,QUESTIONNAIRES ,RHINOPLASTY ,SURGICAL stents ,SURVEYS ,PHENOTYPES ,CROSS-sectional method ,RETROSPECTIVE studies ,SEVERITY of illness index ,SYMPTOMS ,CHILDREN ,DIAGNOSIS - Abstract
Objective: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. Design: Retrospective cross-sectional study. Setting: Cleft Lip and Palate Program, Children's Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey. Interventions: Nasal Obstruction Symptom Evaluation surveys completed at each annual visit. Main Outcome Measures: Composite NOSE and individual symptom scores. Results: Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms (P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes (P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery (P = .006). There was no significant difference (P > .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding. Conclusions: There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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