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CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(03): 371-376
DOI: 10.1055/s-0040-1714768
Original Article

A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

Tulasi Nayak
1   Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences, Jayanagar, Bengaluru, India
,
Renu Parmar
2   Department of Oral and Maxillofacial Surgery, Smile Train Cleft Centre, Bhagwan Mahaveer Jain Hospital, Bangalore
,
Krishnamurthy Bonanthaya
2   Department of Oral and Maxillofacial Surgery, Smile Train Cleft Centre, Bhagwan Mahaveer Jain Hospital, Bangalore
,
Pritham Shetty
2   Department of Oral and Maxillofacial Surgery, Smile Train Cleft Centre, Bhagwan Mahaveer Jain Hospital, Bangalore
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Abstract

Background Nasoalveolar molding (NAM) has been extensively used as a presurgical technique in the treatment of unilateral cleft lip and palate (UCLP) over the last two decades. It has proven to be a useful tool to reduce the cleft size, improve nasal symmetry, and increase the columellar length. The long-term stability of these findings has not been conclusively proven.

Methods In this longitudinal study, the nasal symmetry of 24 NAM treated UCLP patients was evaluated to assess the 5-year stability of NAM. The basal photographs were shot postcheiloplasty (T1), at 1-year follow-up (T2), at 3-year follow-up (T3), and 5-year follow-up (T4) appointments.

Results In this study, we found that NAM was a useful adjuvant in achieving nasal symmetry in patients with UCLP in the immediate postoperative period. However, as the patients aged, there was a gradual loss of mean nasal height (by 22.83%) and columella length (by 24.89%), a mean gain in nasal width (by 40.25%) and alar base width (by 40.69%), and an increase in the columella deviation (by 3.46%) from the T1 to the T4 follow-up.

Conclusion Although there is no conclusive evidence, the loss of symmetry may be due to the unequal growth on the cleft and noncleft sides. These patients will be followed-up till end of growth for a definite conclusion on the long-term effect of NAM.

Keywords

cleft lip - cleft nose - long term - nasal symmetry - nasoalveolar molding


Publication History

Article published online:
04 August 2020

© 2020. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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