Effects of nasoalveolar molding therapy on nasal and alveolar morphology in unilateral cleft lip and palate.J Craniofac Surg 2009; 20(6):2075-80JC
The objective of this study was to evaluate the effects of presurgical nasoalveolar molding (PNAM) therapy on nasal and alveolar tissues in patients with unilateral cleft lip and palate.
PATIENTS AND METHODS
Twenty-two patients with a mean age of 23 days, having complete unilateral cleft lip and palate, were included in this prospective study. After the impressions were taken of the palatal and nasolabial regions separately, the maxillary and nasal plaster models were scanned for linear, angular, and area measurements before and after PNAM therapy. The distances between the identified landmarks were measured in the maxillary casts, and the distance and area measurements were performed for the nasal casts with the specified software called Image J developed by the National Institutes of Health. All subjects have undergone PNAM therapy for 6 months. The nasal and maxillary casts are scanned, and the images were evaluated using the software Image J. The alveolar segments should be approximated, and the cleft width and alar base of the affected side after PNAM should be reduced, and the nostril area of the cleft side should be increased. The columella deviation should be decreased.
The decrease of the cleft width, arch length, and alar base width on the cleft side and the deviation of the columella were significant, in addition to the significant increase of the arch circumference and nostril area on the affected side (P < 0.001).
Presurgical nasoalveolar molding therapy is a significantly helpful treatment for patients with unilateral cleft lip and palate. The reduction in the alveolar cleft region and the nasal reshaping are favorable.