A comparison of results using nasoalveolar moulding in cleft infants treated within 1 month of life versus those treated after this period: development of a new protocol.
The objectives of this study were to: evaluate the effects of nasoalveolar moulding (NAM) in complete unilateral cleft lip and palate infants presenting for treatment at different ages; propose a new NAM protocol in these patients; improve the predictability of NAM. Study groups comprised: group I (n=15) treated with NAM within 1 month of age; group II (n=15) treated with NAM between 1 and 5 months of age.


METHODS
group III (n=15) comprised of non-cleft 18-month old children. A standard protocol was followed. Patients were evaluated before initiation of NAM, before cheiloplasty and at 18 months. 7 linear anthropometric measurements were compared using dento-facial models. Statistical analysis before and after NAM revealed that group I patients demonstrated 81%, 198%, 69% and 145% improvement in intersegment distance, nasal height, nasal dome height and columella height respectively; whilst group II patients demonstrated 51%, 33%, 21% and 38% improvement for the same. At 18 months, group I patients closely resembled group III patients. This study concluded that the effects of NAM were most significant in group I. Group II patients also benefited from NAM, although to a lesser extent. This study validates the use of NAM in infants presenting late for treatment.
Nitte Meenakshi Institute of Craniofacial Surgery, A Unit of A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, India. vshetty@hotmail.com
V
V
Shetty
H J
HJ
Vyas
S M
SM
Sharma
H F
HF
Sailer
D000367:Age Factors; D000539:Alveolar Process / Q000473:pathology; D002508:Cephalometry / Q000379:methods; D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D002985:Clinical Protocols; D003299:Cooperative Behavior; D003376:Counseling; D003724:Dental Arch / Q000473:pathology; D017267:Dental Prosthesis Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D008297:Male; D008437:Maxilla / Q000473:pathology; D055171:Nasal Cartilages / Q000473:pathology; D009666:Nose / Q000473:pathology; D010158:Palatal Obturators; D010290:Parents / Q000193:education; D011300:Preoperative Care; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D015607:Stents; D016896:Treatment Outcome