Presurgical nasoalveolar molding therapy for the treatment of unilateral cleft lip and palate: a preliminary study.
OBJECTIVE
To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP).


METHODS
A prospective study with blinded measurements.


METHODS
Twelve patients with UCLP treated from 1997 to 2003.


METHODS
The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days.


METHODS
Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements.


RESULTS
After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05).


CONCLUSIONS
PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.
Ezzat
Christopher F
CF
Department of Pediatrics, The University of Texas Health Science Center, Houston, Texas, USA.
Chavarria
Carmen
C
Teichgraeber
John F
JF
Chen
Jung-Wei
JW
Stratmann
Robin G
RG
Gateno
Jaime
J
Xia
James J
JJ
D000539:Alveolar Process / Q000473:pathology; D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D005146:Facial Asymmetry / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D003765:Models, Dental; D009666:Nose / Q000473:pathology; D019637:Orthopedic Procedures / Q000295:instrumentation*; D010158:Palatal Obturators; D011300:Preoperative Care; D011446:Prospective Studies; D016037:Single-Blind Method; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome