The Effect of Nasoalveolar Molding and Postoperative Changes of Nasal Symmetry: A 3-Year Study on Nasal Casts

• Main Authors: I Ju Chen, 陳怡如
• Other Authors: Y. R. Chen
• Format: Others
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/q29mb5

碩士 === 長庚大學 === 顱顏口腔醫學研究所 === 96 === Infants with cleft lip and palate present with lip, alveolar, and nasal deformities. Nasoalveolar molding (NAM) has been proposed as a technique to reduce the severity of nasal and alveolar deformities preoperatively. The purpose of this study was to assess the effects of NAM, primary cheiloplasty, and the yearly growth/relapse of nasal symmetry up to three years postoperatively. Twenty-six consecutive complete unilateral cleft lip and palate infants who had NAM were included. Series of nasal casts were obtained before (mean=13.7 days) and after NAM (mean treatment duration= 3 months), 1 month after cheiloplasty, and then yearly for 3 years. The nasal casts were first marked for the landmarks, oriented with the nostrils parallel to the floor, and then mounted on a standardized photograph stand. The images were then taken and input into an image software for the linear measurements. The nostril height, nasal dome height, columella length, nostril width, and nasal basal width were measured. The results revealed that NAM is an effective adjuvant technique for the correction of nasal asymmetry before cheiloplasty. The technique of NAM used in this study was more effective in the correction of the vertical than horizontal nasal asymmetry. The vertical nasal asymmetry was corrected preoperatively by NAM, while the nasal horizontal asymmetry was corrected by surgery. The correction of vertical nasal asymmetry by NAM was more stable than the correction of horizontal nasal asymmetry by cheiloplasty, which relapsed significantly in the first year postoperatively. The vertical and horizontal nasal symmetry remained stable in the 2nd and 3rd year postoperatively. The relapse of horizontal nasal asymmetry was due to the differential growth/relapse between the cleft and noncleft sides in the first year postoperatively. Surgical overcorrection of the nasal asymmetry, especially the horizontal asymmetry, and postoperative maintenance with a nasal conformer for at least a year are recommended.