Changes in nasal symmetry after presurgical nasoalveolar molding in infants treated with complete unilateral cleft lip and palate: A follow‑up study

Abstract

Background: A significant improvement in the nasal symmetry after presurgical nasoalveolar
molding (PNAM) is seen in complete unilateral cleft lip and palate (UCLP) infants. However, the
follow‑up changes in the nasal symmetry before and after PNAM and surgical repair have not been
well documented.
Materials and Methods: The purpose of this retrospective study is to assess the progressive
changes in the nasal symmetry after PNAM and primary cheiloplasty to 1 year in complete UCLP
infants. Out of 28 complete UCLP patients who were given PNAM treatment during the period
between January 2014 to March 2019, 19 UCLP infants could be included for the study. Submental
oblique photographs at the initial visit (T1), immediately after cheiloplasty (T2), and 1 year (T3)
after cheiloplasty were selected, and quantity of nasal asymmetry at each period (T1–T2; T1–T3;
and T2–T3) was analyzed by paired t‑test (P < 0.05).
Results: The quantity of asymmetry revealed that there was a highly significant improvement (P < 0.001)
in nasal asymmetry at T1–T2 and T1–T3. Nonsignificant relapse was observed at T2–T3; however,
a significant relapse in nasal dome height was observed during this period.
Conclusion: The improvement in the nasal symmetry after cheiloplasty in PNAM‑treated patients
is maintained till 1 year postsurgically though there is a nonsignificant relapse.
Key Words: Cleft lip, cleft palate, follow‑up studies, nasoalveolar molding