title: Symmetry of the nose after presurgical nasoalveolar molding in infants with unilateral cleft lip and palate: a preliminary study.
abstract: OBJECTIVE
  To assess nostril symmetry and alveolar cleft width in infants with unilateral cleft lip and palate following presurgical nasoalveolar molding (NAM).
  
  
  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 degrees , 69.9 degrees , 91.2 degrees , and 86.9 degrees 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.
authors.affiliation: Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
authors.forename: Betty Chien-Jung
authors.initials: BC
authors.lastname: Pai
authors.forename: Ellen Wen-Ching
authors.initials: EW
authors.lastname: Ko
authors.forename: Chiung-Shing
authors.initials: CS
authors.lastname: Huang
authors.forename: Eric Jen-Wein
authors.initials: EJ
authors.lastname: Liou
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities / Q000473:pathology; D002356:Cartilage / Q000473:pathology; D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D005146:Facial Asymmetry / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008046:Lip / Q000601:surgery; D008297:Male; D009666:Nose / Q000002:abnormalities / Q000473:pathology*; D010158:Palatal Obturators; D011300:Preoperative Care; D019736:Prostheses and Implants; D011474:Prosthesis Design; D015607:Stents