Presurgical nasoalveolar moulding in unilateral cleft lip and palate.
BACKGROUND
Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate.


OBJECTIVE
The study was conducted to evaluate the efficacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages.


METHODS
Prospective study.


METHODS
A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla.


METHODS
Student's t-test for paired comparisons.


RESULTS
Results of the study showed a promising reduction in the cleft size before the surgery, significant improvement in nasal symmetry, including the columellar length on the cleft side.


CONCLUSIONS
PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.
Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Mohammed
M
Zuhaib
Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Krishnamurthy
K
Bonanthaya
Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Renu
R
Parmar
Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Pritham N
PN
Shetty
Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Pradeep
P
Sharma
Nasal moulding bulb; presurgical nasoalveolar moulding; unilateral cleft lip and palate