Abstract:
Objective To study the morphology of unilateral complete cleft lip and palate (UCLP) infants during pre-surgical nasal-alveolar molding (PNAM) and after cheiloplasty.
Methods From 2019 to 2021, 23 infants with unilateral complete cleft lip and palate were recruited, and 10 infants (6 males and 4 females) were selected for the study. The infants were treated with PNAM after the first visit within 2 weeks after birth and cheiloplasty in about 3 months after birth. During the treatment, three dimensional images were recorded and measured by 3dMD system every two weeks during PNAM (2, 4, 6, 8, 10, 12 weeks after born) as well as in one week and half a year after cheiloplasty, i.e., 8 nodes in total. A total of 14 indices of maxillofacial morphology were recorded every time, which were grouped into lip growth index, nasal growth index and nasal deformity development index. Data analysis was performed by paired-samples t test with SPSS 19.0.
Results The developmental curve of maxillofacial morphology of UCLP infants with PNAM and cheiloplasty was obtained. During the preoperative correction period and PNAM, the growth index of both sides kept increasing, with statistical difference. The nasal deformity development index of cleft side decreased constantly: ac′-prn reduced from (18.5 ± 1.6) mm to (17.1 ± 1.0) mm (t = 4.03, P = 0.003) ; sbal′-sn reduced from (20.5 ± 3.5) mm to (17.7 ± 3.3) mm (t = 3.91, P = 0.004) ; sn″-c′ reduced from (1.8 ± 0.4) mm to (4.7 ± 0.6) mm (t = 4.12, P = 0.003) . The height of nasal column as well as the height and length of lip increased one week after cheiloplasty: sn″-c′ increased from (4.7 ± 0.6) mm to (5.8 ± 0.6) mm (t = 3.41, P = 0.008) , whereas the width of nose floor and length of nose wing decreased, while the slant angle of the nasal columella (∠α) reduced from (29.0 ± 12.7) ° to (5.3 ± 3.4) ° (t = 6.34, P<0.001) . There was no significant statistical difference before and after surgery in normal side (P>0.05) . In half a year after cheiloplasty, the growth trend of the normal side was maintained, and the growth index of the cleft side remained unchanged.
Conclusions During PNAM, the nasal column height and nasal wing morphology of the infants with unilateral complete cleft lip and palate were improved gradually, but the growth and development of the cleft side were not limited. The symmetry of nasolabial triangle area was improved after cheiloplasty, and the therapeutic effect could be maintained half a year after treatment.
Key words:
Infant,
Unilateral cleft lip and palate,
Pre-surgical nasal-alveolar molding,
Sequential treatment,
Maxillofacial development,
3D-measurement
Yaqi Zheng, Man Zhao, Guofeng Wu. Preliminary study on effect of pre-surgical nasal-alveolar molding on maxillofacial three-dimensional morphology of unilateral complete cleft lip and palate infants[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2022, 16(02): 82-88.