Symmetry of the Nose after Presurgical Nasoalveolar Molding in Infants with Unilateral Cleft Lip and Palate: A Preliminary Study

2005 ◽  
Vol 42 (6) ◽  
pp. 658-663 ◽  
Author(s):  
Betty Chien-Jung Pai ◽  
Ellen Wen-Ching Ko ◽  
Chiung-Shing Huang ◽  
Eric Jen-Wein Liou
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Width Ratio ◽  
Initial Visit ◽  
Height Ratio ◽  
Alveolar Cleft ◽  
Direct Measurements ◽  
Preliminary Study ◽  
Nasoalveolar Molding ◽  
Height Data

Objective To assess nostril symmetry and alveolar cleft width in infants with unilateral cleft lip and palate following presurgical nasoalveolar molding (NAM). Sample and Methods Fifty-seven newborn patients underwent presurgical nasoalveolar molding. Magnified basal view facial photos were taken at four different times: initial visit (T1), before cheiloplasty (T2), 1 month after cheiloplasty (T3), and 1 year of age (T4). Direct measurements from the photos included: (1) nostril width on the affected and nonaffected side; (2) nostril height on the affected and nonaffected side; (3) columella—nasal base angle; and (4) width of the alveolar cleft. Nostril width and height data were used to calculate a ratio of affected to nonaffected side. Results Effects of nasal symmetry after presurgical nasoalveolar molding were compared between the affected and nonaffected side. The nostril width ratio was 1.7, 1.2, 1.0, and 1.2 for T1 to T4. The nostril height ratio was 0.5, 0.8, 1.0, and 0.9 for T1 to T4. The angle of the columella was 53.3°, 69.9°, 91.2°, and 86.9° for T1 to T4. The average alveolar cleft width was 8.2 mm at T1 and closed down to 2.4 mm before cheiloplasty (T2) in cases with complete cleft. Conclusions Infants with presurgical nasoalveolar molding improved symmetry of the nose in width, height, and columella angle, as compared to their presurgical status. There was some relapse of nostril shape in width (10%), height (20%), and angle of columella (4.7%) at 1 year of age.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate: A Preliminary Study

2007 ◽  
Vol 44 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Christopher F. Ezzat ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jung-Wei Chen ◽  
Robin G. Stratmann ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Significant Positive Correlation ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
Alveolar Cleft ◽  
Arch Width ◽  
Preliminary Study ◽  
A Prospective Study ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP). Design: A prospective study with blinded measurements. Patients: Twelve patients with UCLP treated from 1997 to 2003. Interventions: The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days. Main Outcome Measures: Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements. Results: After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05). Conclusions: PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

scholarly journals ASSESSMENT OF PRESURGICAL NASOALVEOLAR MOULDING (PNAM) IN UNILATERAL CLEFT LIP AND PALATE

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Santosh Kumar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Intervention Group ◽  
Control Group ◽  
Width Ratio ◽  
Long Term Effects ◽  
Important Indicator ◽  
Medical College ◽  
Significant Difference ◽  
Nasoalveolar Molding

Background: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of Presurgical Nasoalveolar Molding (PNAM) on Midface symmetry in children treated for CUCLP. Material and Methods: This case-control study was carried out in the Department of Burn and Plastic Surgery at Government Medical College and Hospital, Bettiah, Bihar, India from may 2018 to Dec 2019. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1) initial (2) postsurgical. 30 nasal molding patients and 20 control patients were included. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Results: A statistically significant difference was found for postsurgical nostril height-width ratio (P< .05). No other statistically significant differences were found. Conclusion: Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding

scholarly journals Presurgical nasoalveolar molding therapy in cleft lip and palate individuals: Case series and review

2015 ◽  
Vol 5 ◽  
pp. 208-214
Author(s):  
Narayan H. Gandedkar ◽  
Chng Chai Kiat ◽  
Palaniselvam Kanesan ◽  
Wen Cong Lee ◽  
Por Yong Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Case Series ◽  
Nasal Deformity ◽  
Alveolar Cleft ◽  
Nasoalveolar Molding

The nasoalveolar molding (NAM) therapy is advocated to reduce the severity of alveolar cleft and nasal deformity. NAM therapy has demonstrated to be an effective method for reducing cleft and improve nose anatomy. This paper presents a case report of three cleft lip and palate individuals treated with NAM therapy. Furthermore, the paper highlights the advantages of NAM therapy along with an enumeration of literature suggesting in favor of NAM therapy and otherwise. Regardless of controversies and divergent views involved with NAM therapy, the immediate success of NAM therapy facilitating primary lip repair surgery cannot be under-emphasized.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Bilateral Cleft Lip and Palate: A Preliminary Study

2006 ◽  
Vol 43 (3) ◽  
pp. 321 ◽  
Author(s):  
Adam L. Spengler ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jaime Gateno ◽  
James J. Xia
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Preliminary Study ◽  
Nasoalveolar Molding
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