Evaluating the Effectiveness of Nasoalveolar Molding in the Management of Children with Unilateral Cleft Lip and Palate: A Cohort Study.

Abstract

Background: Children affected by unilateral cleft lip and palate (UCLP) represent a therapeutic challenge requiring the development of novel therapies, such as the implant of a bioengineered tissue-BIOCLEFT-or the use of nasoalveolar molding (NAM). The objective of this work was to evaluate the effects of NAM on the surgical and aesthetic outcomes of children with UCLP. Methods: A total of 36 children with UCLP treated at a craniofacial malformations management unit were evaluated, including 23 patients treated with presurgical NAM followed by palate surgical correction (NAM group) and 13 patients treated surgically without previous NAM (non-NAM group). Measurements were obtained from each patient immediately before palate surgery, including four linear measurements: nasal ala projection length (NAPL), nasal dome height (NDH), superoinferior alar groove position (S-I AGP), and nasal dome position (M-L NDP), and two angular measurements: columellar deviation (CD) and nasal bridge deviation (NBD). Results: When NAM was used, a significant improvement of the basilar view linear measurements of the patient's nose was found, including the NAPL and NDH, and the frontal view linear measurement M-L NDP, but not S-I AGP. Significant improvements were also observed in the angular measurements of nasal symmetry CD and NBD. All these variables, except the S-I AGP, significantly correlated with the treatment group, and two variables-NAPL and CD-significantly contributed to generate a predictive model developed using binary logistic regression. Conclusions: These findings support the use of NAM to efficiently improve the nasal symmetry and the presurgical outcomes of patients with UCLP.