title: A modified nasoalveolar molding technique for correction of unilateral cleft nose deformity.
abstract: BACKGROUND
  Traditional Figueroa nasoalveolar molding (NAM) requires weekly or biweekly adjustments to remove acrylic from the palatal plate to narrow the alveolar gap. These frequent adjustments create a burden for patients living far from a hospital. To minimize this burden, we developed a modified NAM technique using simplified lip taping and a passive palatal plate. Herein we present our clinical experience and outcomes using the traditional and modified methods.
  
  
  METHODS
  In this blinded, retrospective study of 66 patients with complete unilateral cleft lip and palate, 33 received the traditional NAM and 33 received the modified NAM. Pretreatment and posttreatment facial photographs and clinical charts were used to compare efficacy (nostril height ratio, nostril width ratio, columellar angle, nasal base angle), efficiency (molding frequency), incidence of complications (facial irritation, mucosal ulceration), and medical cost.
  
  
  RESULTS
  Traditional and modified NAM did not differ in treatment efficacy for nostril height ratio (0.88 ± 0.14 vs. 0.90 ± 0.12), nostril width ratio (2.22 ± 0.39 vs. 2.38 ± 0.50), columellar angle (73.5 ± 9.1 degrees vs. 71.3 ± 11.8 degrees), nasal base angle (5.1 ± 2.4 degrees vs. 5.9 ± 2.7 degrees), or alveolar gap width (2.0 ± 2.0 mm vs. 2.0 ± 1.7 mm) (all p > 0.05). Traditional NAM was less efficient, i.e., required more adjustments (8.6 ± 2.0 vs. 6.7 ± 1.1), and cost more (22016.4 ± 2012.7 New Taiwan dollars vs. 20137.6 ± 1173.4 New Taiwan dollars) (both p < 0.001).
  
  
  CONCLUSIONS
  Both NAM techniques similarly improved nasal deformities and reduced alveolar gaps, but the modified technique was more efficient and cost less in terms of insurance reimbursement and supplies (labial tapes).
authors.affiliation: Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yun-Fang
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: yufang@cgmh.org.tw.
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Liao
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities* / Q000601:surgery*; D002971:Cleft Lip / Q000473:pathology / Q000601:surgery; D002972:Cleft Palate / Q000473:pathology / Q000601:surgery; D005145:Face; D006801:Humans; D009666:Nose / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome
keywords: Nasoalveolar molding; Outcome; Unilateral cleft lip palate; Unilateral cleft nose