Recent Advances in Nasoalveolar Molding Therapy Using 3D Technology

Presurgical Nasoalveolar Molding (NAM) is an adjunctive treatment modality designed to reorient misaligned tissue structures and nasal cartilage in cleft lip and/or palate (CL/P) patients. Recent advances in NAM therapy focus on modifications to the intraoral molding plate or nasal stent intended to improve treatment outcomes, ease of use, compliance, and cost-effectiveness. Notably, 3D technological advancements have been employed to design NAM devices more efficiently and create objective, standardized means of measuring progressive morphological changes during therapy. These advances are designed to incorporate 3D technology in the treatment of cleft lip and/or palate to render it more precise, accurate, and time-efficient.

Download Full-text

The Effect of Nasoalveolar Molding on Nasal Airway Anatomy

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617744062 ◽

2018 ◽

Vol 55 (4) ◽

pp. 596-601 ◽

Cited By ~ 3

Author(s):

Jonathan P. Massie ◽

Karl Bruckman ◽

William J. Rifkin ◽

Christopher M. Runyan ◽

Pradip R. Shetye ◽

...

Keyword(s):

Cleft Lip ◽

Inferior Turbinate ◽

Septal Deviation ◽

Nasal Airway ◽

Retrospective Case ◽

Tertiary Referral Center ◽

Nasal Cartilage ◽

Inferior Turbinate Hypertrophy ◽

Nasoalveolar Molding ◽

Control Study

Objective: To determine the effects of nasoalveolar molding (NAM) on nasal airway architecture. Design: Retrospective case-control study of patients with unilateral cleft lip treated with NAM vs without NAM. Setting: Tertiary referral center specializing in cleft and craniofacial care. Patients, Participants, and Interventions: Thirty-six patients with complete unilateral cleft lip and alveolus: 19 with NAM therapy and 17 without NAM therapy. Main Outcome Measures: Cone beam computed tomography (CBCT) scans were compared in multiple coronal sections and were evaluated for linear and angular septal deviation, inferior turbinate hypertrophy, and linear and 2-dimensional airway area. Results: There were no significant differences in linear or angular septal deviation, inferior turbinate area, linear stenosis, or airway area between NAM- and non-NAM-treated patients. Conclusions: NAM effectively molds the external nasal cartilage and structures but may have limited effects on internal nasal structures.

Download Full-text

A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate

European Journal of Dentistry ◽

10.4103/1305-7456.184146 ◽

2016 ◽

Vol 10 (03) ◽

pp. 435-438 ◽

Cited By ~ 6

Author(s):

Chitravelu Siva Subramanian ◽

N. K. K. Koteswara Prasad ◽

Arun B. Chitharanjan ◽

Eric Jein Wein Liou

Keyword(s):

Functional Outcome ◽

Surgical Procedures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Treatment Technique ◽

Patient Needs ◽

Nasal Cartilage ◽

Primary Rhinoplasty ◽

Cleft Lip Repair ◽

Nasoalveolar Molding

ABSTRACTNasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application.

Download Full-text

Effect of Presurgical Nasoalveolar Molding on Nasal Symmetry in Unilateral Complete Cleft Lip/Palate Patients after Primary Cheiloplasty without Concomitant Nasal Cartilage Dissection

The Cleft Palate-Craniofacial Journal ◽

10.1597/14-296 ◽

2018 ◽

Vol 55 (7) ◽

pp. 935-940 ◽

Cited By ~ 5

Author(s):

Zhigang Liang ◽

Jinfeng Yao ◽

Philip K.T. Chen ◽

Cangshang Zheng ◽

Jiying Yang

Keyword(s):

Repeated Measures ◽

Cleft Lip ◽

Early Stage ◽

Statistical Significance ◽

Deformity Correction ◽

Nasal Cartilage ◽

Significant Difference ◽

Cleft Lip Palate ◽

Nasoalveolar Molding

Objective: The objective of this study was to assess the efficacy of presurgical nasoalveolar molding (PNAM) on long-term nasal symmetry and shaping after primary cheiloplasty in patients with unilateral complete cleft lip/palate (UCL/P). Design: This was a two-group, parallel, retrospective, randomized clinical trial. Setting: The setting for this study was the Chang Gung Craniofacial Center in Taoyuan, Taiwan. Patients: Patients were divided into one of the following two groups: infants with UCL/P who underwent PNAM (PNAM group, n = 42) and infants with UCL/P who did not undergo PNAM (non-PNAM group, n = 42). Interventions: Interventions included PNAM and primary cheiloplasty without nasal cartilage dissection. Main Outcome Measures: In this study, 4- to 5-year postoperative full-face and submental oblique photographs were taken of all patients and scored from 1 to 5 points by 10 medical evaluators. The scores were statistically analyzed using repeated-measures analysis of variance, and P < .05 was considered to represent statistical significance. Results: After 1 to 3 months of PNAM but before primary cheiloplasty, the displaced nasal and alveolar cartilage showed obvious improvement. However, the scores in the PNAM and non-PNAM groups at 4 to 5 years postoperatively were 66.62 ± 14.25 and 66.31 ± 15.08, respectively. There was no significant difference between the two groups ( F = 0.009, P = .923). Conclusion: PNAM as an early-stage adjunctive therapy for nasal deformity correction is beneficial before primary cheiloplasty, but it is insufficient to maintain long-term nostril symmetry after primary cheiloplasty without nasal cartilage dissection.

Download Full-text

Three-Dimensional Assessment of Morphological Changes Following Nasoalveolar Molding Therapy in Cleft Lip and Palate Patients: A Case Report

Dentistry Journal ◽

10.3390/dj7010027 ◽

2019 ◽

Vol 7 (1) ◽

pp. 27 ◽

Cited By ~ 8

Author(s):

Edoardo Staderini ◽

Romeo Patini ◽

Andrea Camodeca ◽

Federica Guglielmi ◽

Patrizia Gallenzi

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Morphological Changes ◽

Three Dimensional ◽

Dimensional Changes ◽

Technological Advances ◽

Angular Measurements ◽

The Face ◽

Three Dimensional Images ◽

Nasoalveolar Molding

The applications of computer-guided technologies for three-dimensional image analysis provide a unique opportunity to quantify the morphological dimensional changes of the face in a practical and convenient way. Symmetry of the nasolabial area is one of the main factors of facial attractiveness as well as being the main objective of the treatment of cleft lip and palate (CLP). Technological advances in computer-guided visualization modes and their applications to three-dimensional stereophotogrammetry provide more practical opportunities and alternatives for facial analysis. Each study, however, uses different protocols for the acquisition and analysis of three-dimensional images. In addition, each study identifies different anthropometric points and calculates linear and angular measurements with overlapping protocols. Therefore, it is appropriate to define a standardization of the three-dimensional analysis of CLP patients to compare the studies of different research centers. The aim of this report is to propose a protocol to standardize the acquisition and analysis of three-dimensional images to evaluate the three-dimensional changes in the nasolabial area in cleft lip and palate patients undergoing pre-surgical nasoalveolar molding (PNAM).

Download Full-text