Dynamic Changes in Nasal Symmetry after Presurgical Nasoalveolar Molding in Infants with Complete Unilateral Cleft Lip and Palate

BACKGROUND: Presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the plastic surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively. This therapy not only aids the surgical repair of lip but also enhances the overall postsurgical results with negligible postoperative scar. AIM: The aim of the study was to analyze nasal changes before and after PNAM in patients with complete UCLP. MATERIALS AND METHODS: This was a retrospective review of 22 ULCP patients who underwent PNAM before lip surgeries. A series of standard basilar view photographs in 1:1 ratio were taken, and linear measurements were done directly on the photographs. RESULTS: After PNAM therapy, there was highly significant increase in the nostril height, nostril dome height, and columella length (P < 0.001*) and highly significant reduction in the nostril width and nasal basal width (P < 0.001*). CONCLUSION: Significant improvement in the nasal symmetry was found after PNAM therapy in patients with complete UCLP.