{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T09:34:55Z","timestamp":1777023295814,"version":"3.51.4"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Cleft lip and\/or palate (CLP) is frequently associated with persistent nasal obstruction, often due to structural deformities unaddressed by primary surgical repair. While subjective assessment tools are commonly used to evaluate nasal patency, they underestimate functional impairment, particularly nasal valve collapse. This study aims to objectively evaluate nasal obstruction and identify its anatomical causes in CLP patients after primary rhinoplasty. Methods: We conducted an observational study involving 21 children aged 8\u201316 with CLP who had undergone primary cheilorhinoplasty but not secondary nasal surgery. Each participant underwent clinical evaluation, nasal endoscopy, acoustic rhinometry, and active anterior rhinomanometry (AAR), both before and after nasal decongestion. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess subjective symptoms. Obstructive sites were diagnosed based on established criteria combining endoscopic and functional findings. Results: Objective nasal obstruction was identified in 80.9% of patients, with nasal valve collapse observed in 66.7%, most commonly among unilateral and bilateral CLP subtypes. External nasal valve collapse was the predominant form (57.1%), followed by internal valve involvement (38.1%). Notably, the NOSE score did not reliably correlate with the AAR results, underlining the limitations of subjective assessment tools. Structural anomalies such as septal deviation (52.5%) and turbinate hypertrophy (23.8%) were also prevalent. Conclusions: This study highlights nasal valve collapse as a major, underrecognized contributor to persistent nasal obstruction in CLP patients after primary repair. Objective assessment methods like AAR and targeted endoscopy should be routinely integrated into secondary rhinoplasty planning. These findings advocate for a personalized approach to secondary nasal reconstruction in CLP patients, integrating objective functional data into surgical planning. Such strategies align with personalized medicine principles by tailoring interventions to individual anatomical and physiological characteristics.<\/jats:p>","DOI":"10.3390\/jpm15090403","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T08:23:38Z","timestamp":1756801418000},"page":"403","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Objective Evaluation of Nasal Obstruction in Cleft Lip and Palate Patients: A Preliminary Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Nicolas","family":"Pachebat","sequence":"first","affiliation":[{"name":"Service d\u2019ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Mil\u00e9trie, F-86000 Poitiers, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiad N.","family":"Mcheik","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"},{"name":"Service de Chirurgie P\u00e9diatrique, Centre Hospitalier Universitaire de Poitiers, F-86000 Poitiers, France"},{"name":"Laboratoire Inflammation, Tissus Epith\u00e9liaux et Cytokines, LITEC UR 155-60, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8317-2286","authenticated-orcid":false,"given":"Maxime","family":"Fieux","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Lyon Sud, F-69003 Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7999-951X","authenticated-orcid":false,"given":"Valentin","family":"Favier","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Montpellier, F-34295 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4378-0583","authenticated-orcid":false,"given":"Aur\u00e9lien","family":"Binet","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"},{"name":"Service de Chirurgie P\u00e9diatrique, Centre Hospitalier Universitaire de Poitiers, F-86000 Poitiers, France"},{"name":"CNRS UMR7267, \u00c9cologie et Biologie des Interactions, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Dufour","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Mil\u00e9trie, F-86000 Poitiers, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"},{"name":"Service de Chirurgie P\u00e9diatrique, Centre Hospitalier Universitaire de Poitiers, F-86000 Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-8559","authenticated-orcid":false,"given":"Florent","family":"Carsuzaa","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Mil\u00e9trie, F-86000 Poitiers, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Poitiers, F-86000 Poitiers, France"},{"name":"Service de Chirurgie P\u00e9diatrique, Centre Hospitalier Universitaire de Poitiers, F-86000 Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"511e","DOI":"10.1097\/PRS.0b013e3182402dd1","article-title":"Updating the Epidemiology of Cleft Lip with or without Cleft Palate","volume":"129","author":"Tanaka","year":"2012","journal-title":"Plast. 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