Presurgical nasoalveolar moulding in unilateral cleft lip and palate

Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management...

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Main Authors: Mohammed Zuhaib, Krishnamurthy Bonanthaya, Renu Parmar, Pritham N. Shetty, Pradeep Sharma
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2016-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.182235
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author Mohammed Zuhaib
Krishnamurthy Bonanthaya
Renu Parmar
Pritham N. Shetty
Pradeep Sharma
author_facet Mohammed Zuhaib
Krishnamurthy Bonanthaya
Renu Parmar
Pritham N. Shetty
Pradeep Sharma
author_sort Mohammed Zuhaib
collection DOAJ
description Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.
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spelling doaj.art-0bae6dbdf26d421a82b82bca4f4c262c2022-12-21T18:21:38ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2016-01-014901425210.4103/0970-0358.182235Presurgical nasoalveolar moulding in unilateral cleft lip and palateMohammed Zuhaib0Krishnamurthy Bonanthaya1Renu Parmar2Pritham N. Shetty3Pradeep Sharma4Department of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, IndiaDepartment of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, IndiaDepartment of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, IndiaDepartment of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, IndiaDepartment of Oral and Maxillofacial Surgery, Bhagwaan Mahaveer Jain Hospital, Bengaluru, Karnataka, IndiaContext: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.182235nasal moulding bulbpresurgical nasoalveolar mouldingunilateral cleft lip and palate
spellingShingle Mohammed Zuhaib
Krishnamurthy Bonanthaya
Renu Parmar
Pritham N. Shetty
Pradeep Sharma
Presurgical nasoalveolar moulding in unilateral cleft lip and palate
Indian Journal of Plastic Surgery
nasal moulding bulb
presurgical nasoalveolar moulding
unilateral cleft lip and palate
title Presurgical nasoalveolar moulding in unilateral cleft lip and palate
title_full Presurgical nasoalveolar moulding in unilateral cleft lip and palate
title_fullStr Presurgical nasoalveolar moulding in unilateral cleft lip and palate
title_full_unstemmed Presurgical nasoalveolar moulding in unilateral cleft lip and palate
title_short Presurgical nasoalveolar moulding in unilateral cleft lip and palate
title_sort presurgical nasoalveolar moulding in unilateral cleft lip and palate
topic nasal moulding bulb
presurgical nasoalveolar moulding
unilateral cleft lip and palate
url http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.182235
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AT renuparmar presurgicalnasoalveolarmouldinginunilateralcleftlipandpalate
AT prithamnshetty presurgicalnasoalveolarmouldinginunilateralcleftlipandpalate
AT pradeepsharma presurgicalnasoalveolarmouldinginunilateralcleftlipandpalate