J Korean Assoc Oral Maxillofac Surg.  2021 Aug;47(4):257-268. 10.5125/jkaoms.2021.47.4.257.

Comparative evaluation of nasal and alveolar changes in complete unilateral cleft lip and palate patients using intraoral and extraoral nasoalveolar molding techniques: randomized controlled trial

• Kalaskar R
• Bhaje P
• Sharma P
• Balasubramanian S
• Ninawe N
• Ijalkar R

• KMID: 2519823
• DOI: http://doi.org/10.5125/jkaoms.2021.47.4.257

Abstract

Objectives
Cleft lip and palate is a common congenital anomaly that impairs the aesthetics, speech, hearing, and psychological and social life of an individual. To achieve good aesthetic outcomes, presurgical nasoalveolar molding (NAM) has become important. Currently, the intraoral NAM technique is widely practiced. Numerous modifications have been made to intraoral NAM techniques, but the original problem of compliance leading to discontinuation of treatment remains unsolved. Therefore, the present study compared an extraoral NAM technique with the intraoral NAM technique.
Materials and Methods
Twenty infants with complete unilateral cleft lip and palate were included and divided into two equal groups. Group A received the intraoral NAM technique, and Group B received the extraoral NAM technique. Pre- and postoperative extraoral and intraoral measurements were recorded.
Results
Groups A and B did not differ significantly in any extraoral or intraoral parameter.
Conclusion
The extraoral NAM technique is as effective as the intraoral NAM technique in achieving significant nasal and alveolar changes in complete unilateral cleft lip and palate patients. Additionally, it reduces the need for frequent hospital visits for activation and the stress associated with the insertion and removal of the intraoral NAM plate, thereby improving compliance.

Keyword

Cleft lip and palate; Nasal and alveolar changes; Extraoral NAM technique; Nasal stent; Compliance

Figure

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  Fig. 1 Photograph of intraoral (A) and extraoral (B) nasoalveolar molding (NAM) appliances.

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  Fig. 2 Photograph showing extraoral anthropometric measurements of cleft lip and palate. A. Soft tissue cleft width. B. Total alar base width. C. Columella length. D. Nostril width on cleft and non-cleft side. E. Nostril height on cleft and on-cleft side.

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  Fig. 3 Photograph showing intraoral measurements on cleft lip and palate cast. A. Anterior alveolar cleft width. B. Length of larger and smaller segment.

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  Fig. 4 Photograph showing pre- and postoperative nasal and alveolar changes in Group A. A. Preoperative photograph. B. Preoperative cleft lip and palate (CLP) cast. C. Postoperative photograph. D. Postoperative CLP cast. E. Appliance in place.

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  Fig. 5 Photograph showing pre and postoperative nasal and alveolar changes in Group B. A. Preoperative photograph. B. Preoperative cleft lip and palate (CLP) cast. C. Appliance in place. D. Postoperative photograph. E. Postoperative CLP cast. F. Appliance in place.

Reference

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