Presurgical technique for nasal deformity correction in cleft lip patients

Nasal deformities are very common in unilateral cleft lip cases.

Objective: The aim of this study was to determine the effect of presurgical nasoalveolar molding using nasal stent attached to feeding plate on nasal shape in infants with complete unilateral cleft lip and palate. Materials and Methods: seven infants were selected for this study referred to Prosthodontic Clinic, Faculty of Dentistry, Tanta University, Their age ranged from 3-8 months. All infants had unilateral cleft lip and palate. Palatal plate (feeding plate) was constructed using Light-cured resin (Triad, Dentsply Int., York, PA). A hollow, small size plastic tube was attached to the feeding plate, then successive layers of light cure resin were adapted to the plastic tube for optimum building the ala of the nose. The infants were recalled every week for any adjustments.

Photographs before nasoalveolar molding were taken for the infants and other photographs were recorded 3 w., 6w., and after 9 weeks of using the appliance. All the data photographs of the children were obtained and enlarged to produce an alar base width of 12 cms on a frontal view. The symmetry of the nose was measured using multidata computer system DDS software.

Results: The gradual reshaping of the nasal extension that arises from the forward edge of the feeding plate (nasal stent) significantly changed the nasal shape after 9 weeks of using the appliance. Conclusion: Presurgical nasoalveolar molding significantly increases the symmetry of the nose and proper contouring of alveolar bone growth.