title: Effect of Presurgical Nasoalveolar Molding on Nasal Symmetry in Unilateral Complete Cleft Lip/Palate Patients after Primary Cheiloplasty without Concomitant Nasal Cartilage Dissection: Early Childhood Evaluation.
abstract: The objective of this study was to assess the efficacy of presurgical nasoalveolar molding (PNAM) on long-term nasal symmetry and shaping after primary cheiloplasty in patients with unilateral complete cleft lip/palate (UCL/P).
  
  
  
  This was a two-group, parallel, retrospective, randomized clinical trial.
  
  
  
  The setting for this study was the Chang Gung Craniofacial Center in Taoyuan, Taiwan.
  
  
  
  Patients were divided into one of the following two groups: infants with UCL/P who underwent PNAM (PNAM group, n = 42) and infants with UCL/P who did not undergo PNAM (non-PNAM group, n = 42).
  
  
  
  Interventions included PNAM and primary cheiloplasty without nasal cartilage dissection.
  
  
  
  In this study, 4- to 5-year postoperative full-face and submental oblique photographs were taken of all patients and scored from 1 to 5 points by 10 medical evaluators. The scores were statistically analyzed using repeated-measures analysis of variance, and P < .05 was considered to represent statistical significance.
  
  
  
  After 1 to 3 months of PNAM but before primary cheiloplasty, the displaced nasal and alveolar cartilage showed obvious improvement. However, the scores in the PNAM and non-PNAM groups at 4 to 5 years postoperatively were 66.62 ± 14.25 and 66.31 ± 15.08, respectively. There was no significant difference between the two groups ( F = 0.009, P = .923).
  
  
  
  PNAM as an early-stage adjunctive therapy for nasal deformity correction is beneficial before primary cheiloplasty, but it is insufficient to maintain long-term nostril symmetry after primary cheiloplasty without nasal cartilage dissection.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Liang
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Yao
authors.forename: Philip K T
authors.initials: PKT
authors.lastname: Chen
authors.forename: Cangshang
authors.initials: C
authors.lastname: Zheng
authors.forename: Jiying
authors.initials: J
authors.lastname: Yang
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities*; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008445:Maxillofacial Development; D055171:Nasal Cartilages; D009666:Nose / Q000002:abnormalities* / Q000601:surgery; D019637:Orthopedic Procedures / Q000295:instrumentation*; D010158:Palatal Obturators; D010781:Photography; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
keywords: nasal deformity; presurgical nasoalveolar molding; unilateral complete cleft lip/palate (UNCL/P)