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. 2020 Dec;53(3):371-376.
doi: 10.1055/s-0040-1714768. Epub 2020 Aug 4.

A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

Tulasi Nayak  1 , Renu Parmar  2 , Krishnamurthy Bonanthaya  2 , Pritham Shetty  2
Affiliations

A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

Tulasi Nayak et al. Indian J Plast Surg. 2020 Dec.

Abstract

Background Nasoalveolar molding (NAM) has been extensively used as a presurgical technique in the treatment of unilateral cleft lip and palate (UCLP) over the last two decades. It has proven to be a useful tool to reduce the cleft size, improve nasal symmetry, and increase the columellar length. The long-term stability of these findings has not been conclusively proven. Methods In this longitudinal study, the nasal symmetry of 24 NAM treated UCLP patients was evaluated to assess the 5-year stability of NAM. The basal photographs were shot postcheiloplasty (T1), at 1-year follow-up (T2), at 3-year follow-up (T3), and 5-year follow-up (T4) appointments. Results In this study, we found that NAM was a useful adjuvant in achieving nasal symmetry in patients with UCLP in the immediate postoperative period. However, as the patients aged, there was a gradual loss of mean nasal height (by 22.83%) and columella length (by 24.89%), a mean gain in nasal width (by 40.25%) and alar base width (by 40.69%), and an increase in the columella deviation (by 3.46%) from the T1 to the T4 follow-up. Conclusion Although there is no conclusive evidence, the loss of symmetry may be due to the unequal growth on the cleft and noncleft sides. These patients will be followed-up till end of growth for a definite conclusion on the long-term effect of NAM.

Keywords: cleft lip; cleft nose; long term; nasal symmetry; nasoalveolar molding.

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Conflict of interest statement

Conflict of interest We have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
NAM–basal photograph pre-NAM. Abbreviation: NAM, nasoalveolar molding.
Fig. 2
Fig. 2
NAM–basal photograph post-NAM. Abbreviation: NAM, nasoalveolar molding.
Fig. 3
Fig. 3
NAM–basal photograph postcheiloplasty (T1 follow-up). Abbreviation: NAM, nasoalveolar molding.
Fig. 4
Fig. 4
NAM–basal photograph at 1-year follow-up (T2 follow-up). Abbreviation: NAM, nasoalveolar molding.
Fig. 5
Fig. 5
NAM–basal photograph at 3-year follow-up (T3 follow-up). Abbreviation: NAM, nasoalveolar molding.
Fig. 6
Fig. 6
NAM–basal photograph at 5-year follow-up (T4 follow-up). Abbreviation: NAM, nasoalveolar molding.
Fig. 7
Fig. 7
Columella deviation angle measurement.
Fig. 8
Fig. 8
Nasal height measurement (red–cleft side, black–noncleft side).
Fig. 9
Fig. 9
Nasal width measurement (red–cleft side, black–noncleft side).
Fig. 10
Fig. 10
Columella length measurement (red–cleft side, black–noncleft side).
Fig. 11
Fig. 11
Alar base width measurement (red–cleft side, black–noncleft side).
See this image and copyright information in PMC

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