Evaluation of preoperative naso‑alveolar molding in correction of unilateral complete cleft lip and palate associated with nasal deformity

Mahmoud El‑Bestara, Mamdouh Aboulhassanb, Nermin Z. Fahmyc, Adel El‑Antablya

Departments of aOtorhinolaryngology bPaediatric Plastic Surgery, Faculty of Medicine, Cairo University, Cairo cDepartment of Otorhinolaryngology Specialist, Ministry of Health, Cairo, Egypt

Complete cleft lip and palate (CLP) is a common congenital middle‑third facial defect, which has considerable medical, economic, social, and psychological consequences for the affected individuals and their families. Many surgical techniques had evolved for correction, but the displacement of the lower lateral nasal cartilage is considered a challenge for the surgeon. Preoperative naso‑alveolar molding (NAM) aims at alignment of tissues, thus improving the surgical outcome. The aim of the current study was to assess the outcome of the use of NAM as a presurgical orthodontic modality for the treatment of patients with unilateral complete CLP associated with nasal deformity.
Patients and methods
This prospective controlled study was conducted on 16 randomly selected patients with unilateral complete CLP associated with nasal deformity. They were divided randomly into two equal groups. One group included eight patients who underwent presurgical NAM therapy,
and the other one included eight patients who underwent surgical repair only as a control.
A statistically significant difference was found regarding the hemicolumellar height ratio.
Although alar base width values were slightly smaller in presurgical NAM therapy group, no statistically significant difference was found for the alar base width values or the domal angles.
Presurgical NAM proved superior postsurgical nasal symmetry compared with controls regarding the nostril height. The parents of patients with unilateral complete CLP associated with nasal deformity should be counselled to have presurgical NAM to improve the surgical outcome.
cleft lip, cleft palate, orthodontics.

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