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Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose.
Cleft Palate Craniofac J. 2012 Nov; 49(6):689-700.CP

Abstract

PURPOSE

Nasal reconstruction for patients with unilateral cleft lip and palate (UCLP) is a challenge for the reconstructive surgeon. Presurgical nasoalveolar molding (PNAM) was introduced to reshape the cleft nasal structures prior to lip repair. This study analyzed two-dimensional nasal changes before and after PNAM in patients with complete UCLP.

METHODS

Thirty UCLP patients (19 males; 11 females) who received PNAM before lip repair were included in this study. PNAM was applied for 100 days. Nasal casts were obtained before and after PNAM. Frontal and 45° standardized digital photographs were taken from all casts, and a photogrammetric analysis (16 linear, six angular, and two area measurements) was performed. Paired Student's t tests were used to search for differences by time, and time versus side (cleft versus noncleft).

RESULTS

Significant reduction of cleft columella deviation with an increase in columella length, nostril height, and axial inclination on the cleft side were recorded. This resulted in an increase in the projection of the nasal tip. The noncleft measurements remained without significant changes. The cleft nostril area increased significantly more than the noncleft side by 90% with PNAM treatment. Significant normal growth changes were observed in nasal width and nasal height.

CONCLUSION

A favorable reshaping of the nose after PNAM was achieved, resulting in an improvement in form before lip surgery. These changes lead to improved nasal symmetry before primary lip and nasal reconstruction in UCLP patients.

Authors+Show Affiliations

Rush Craniofacial Center, Rush University Medical Center, Chicago, Illinois, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21846257

Citation

Gomez, David F., et al. "Nasal Changes After Presurgical Nasoalveolar Molding (PNAM) in the Unilateral Cleft Lip Nose." The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 49, no. 6, 2012, pp. 689-700.
Gomez DF, Donohue ST, Figueroa AA, et al. Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose. Cleft Palate Craniofac J. 2012;49(6):689-700.
Gomez, D. F., Donohue, S. T., Figueroa, A. A., & Polley, J. W. (2012). Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose. The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 49(6), 689-700. https://doi.org/10.1597/11-007
Gomez DF, et al. Nasal Changes After Presurgical Nasoalveolar Molding (PNAM) in the Unilateral Cleft Lip Nose. Cleft Palate Craniofac J. 2012;49(6):689-700. PubMed PMID: 21846257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose. AU - Gomez,David F, AU - Donohue,Sean T, AU - Figueroa,Alvaro A, AU - Polley,John W, Y1 - 2011/08/16/ PY - 2011/8/18/entrez PY - 2011/8/19/pubmed PY - 2015/9/29/medline SP - 689 EP - 700 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac. J. VL - 49 IS - 6 N2 - PURPOSE: Nasal reconstruction for patients with unilateral cleft lip and palate (UCLP) is a challenge for the reconstructive surgeon. Presurgical nasoalveolar molding (PNAM) was introduced to reshape the cleft nasal structures prior to lip repair. This study analyzed two-dimensional nasal changes before and after PNAM in patients with complete UCLP. METHODS: Thirty UCLP patients (19 males; 11 females) who received PNAM before lip repair were included in this study. PNAM was applied for 100 days. Nasal casts were obtained before and after PNAM. Frontal and 45° standardized digital photographs were taken from all casts, and a photogrammetric analysis (16 linear, six angular, and two area measurements) was performed. Paired Student's t tests were used to search for differences by time, and time versus side (cleft versus noncleft). RESULTS: Significant reduction of cleft columella deviation with an increase in columella length, nostril height, and axial inclination on the cleft side were recorded. This resulted in an increase in the projection of the nasal tip. The noncleft measurements remained without significant changes. The cleft nostril area increased significantly more than the noncleft side by 90% with PNAM treatment. Significant normal growth changes were observed in nasal width and nasal height. CONCLUSION: A favorable reshaping of the nose after PNAM was achieved, resulting in an improvement in form before lip surgery. These changes lead to improved nasal symmetry before primary lip and nasal reconstruction in UCLP patients. SN - 1545-1569 UR - https://www.unboundmedicine.com/medline/citation/21846257/Nasal_changes_after_presurgical_nasoalveolar_molding__PNAM__in_the_unilateral_cleft_lip_nose_ L2 - http://journals.sagepub.com/doi/full/10.1597/11-007?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -