“IMPACT OF PRESURGICAL NASOALVEOLAR MOLDING ON NASAL AND ALVEOLAR MORPHOLOGY IN INFANTS WITH UNILATERAL CLEFT LIP AND PALATE.”

Abstract

Background: Presurgical nasoalveolar molding is employed to enhance nasal and alveolar alignment in children with unilateral cleft lip and palate, hence potentially improving surgical results. The objective of this study is to evaluate the efficacy of Presurgical feeding palate and modified nasoalveolar molding (NAM) therapy in altering nasal and alveolar morphology in infants with unilateral cleft lip and palate compared to patients with no presurgical preparation .
Methods: A cohort of 25 newborns with unilateral cleft lip and palate received presurgical nasoalveolar molding therapy for a duration of six months, 13 treated with feeding palate and 12 treated with modified nasoalveolar molding, and 10 controls were included in our study.
Results: Feeding plate (Subgroup I) and NAM (Subgroup II) were homogeneous at baseline (p > 0.05). Upon presentation, the patients had a substantial transverse discrepancy (mean 8.45 ± 0.67 mm) and a broad alveolar cleft (mean 10.28 ± 0.67 mm). In addition to preserving longitudinal maxillary growth, the feeding plate considerably decreased cleft width and transverse disparity, resulting in a steady posterior width and a decreased mid-palatal width. Significant early cleft width reduction, mid-palatal and posterior width increases, and better midline alignment were all accomplished with the NAM device. The cleft width and transverse discrepancy were greatly reduced by both presurgical treatments when compared to controls; there was no difference in the decrease of cleft width between the two techniques; all groups' natural maxillary growth was preserved. The NAM group was the only one to significantly enhance nasal symmetry and reduce nasal tip deviation when compared to the feeding plate and controls, according to photometric analysis.

Conclusion: Infants with unilateral cleft lip and palate benefit from both the feeding plate and NAM, which preserve natural maxillary growth while dramatically lowering the width of the alveolar cleft and the transverse maxillary disparity. However, the NAM device offers extra advantages by enhancing columellar alignment and nasal symmetry.