Short-term Evaluation of Changes in Nasal Morphology in UCLP Patients Treated with Presurgical Nasoalveolar Molding at Niigata University Medical and Dental Hospital

Abstract

The aim of this study was to clarify the short-term effect of presurgical nasoalveolar molding （PNAM） treatment on the nasal morphology in patients with unilateral cleft lip and palate （UCLP）. In the study, we successively investigated the nasal morphology from the beginning of PNAM application to 6 months after cheiloplasty.
The subjects were 17 UCLP patients who had been treated at the Orthodontic Clinic, Niigata University Medical and Dental Hospital. The subjects were divided into two groups: the PNAM group （12 patients, 6 males and 6 females）, and the non-PNAM group （5 patients, 2 males and 3 females）. For morphological evaluation of nasal shape, the frontal and worm’s-eye view facial photographs, which had been taken at the first material taking （T1）, immediately before the cheiloplasty （T2） and after the cheiloplasty （T3）, were used. Six angular measurements were determined, and then the average values of those measurements at T1, T2 and T3, and the amount of change of T1-T2 and T2-T3, were compared between the two groups.
At T1, no significant difference was found in all items between the PNAM and non-PNAM groups. At T2, the PNAM group showed significantly smaller values of nasal tip angle and columella inclination angle compared with the non-PNAM group. The angle of the upper margin nostril on the affected side in the PNAM group was larger than that in the non-PNAM group. At T3, only the alar base inclination angle on the frontal view was smaller in the PNAM group than that in the non-PNAM group.
As for the changes of T1-T2 and T2-T3 in the PNAM group, some items showed significant changes both in T1-T2 and T2-T3. In contrast, significant changes were observed only in T2-T3 in the non-PNAM group. These findings suggested that PNAM treatment in our institution improved the deviation of the alar base before cheiloplasty. However, positive effects on the external nasal morphology were not found postoperatively in this study. Further studies are needed to discuss the effect of PNAM treatment.