López-Palacio Ana María, Cerón-Zapata Ana María, Gómez David F, Dávila-Calle Angela P, Ojalvo-Arias María Adelaida
Department of Basic Integrated Studies, College of Dentistry, University of Antioquia, Medellín, Colombia.
Pediatr Dent. 2012 May-Jun;34(3):239-44.
Presurgical nasoalveolar molding (PNAM) is controversial in maxillofacial orthopedics. It supposedly improves the nasal esthetics and function in unilateral cleft lip/palate (UCLP) patients. However, there is no research available in South America to support this claim. The purpose of this study was to evaluate the efficacy of presurgical nasoalveolar molding therapy on morphological changes of the noses of unilateral cleft lip/palate patients in a Colombian sample.
Seventeen neonate UCLP patients using PNAM received facial impressions at the beginning of treatment; before primary rhinocheiloplasty; and before palatoplasty. A submentovertex photograph of each cast was taken and analyzed by digital photogrammetry. Wilcoxon and Friedman tests were used for within- and between-group comparisons.
A statistically significant reduction of cleft nostril width, without significant changes in noncleft nostril width or total nasal width, was found after PNAM. A significant increase in cleft and noncleft nostril height, plus a nonsignificant increase in nostril area in both sides and a nonsignificant uprighting of the columella were found. These changes were maintained or further improved after rhinocheiloplasty.
The presurgical nasoalveolar molding technique improved nasal tip projection and alar cartilage depression and decreased partially columella deviation before rhinocheiloplasty in South American unilateral cleft lip/palate patients.
术前鼻牙槽塑形（PNAM）在颌面整形外科中存在争议。一般认为它能改善单侧唇腭裂（UCLP）患者的鼻部美观和功能。然而，南美洲尚无研究支持这一说法。本研究的目的是评估术前鼻牙槽塑形治疗对哥伦比亚单侧唇腭裂患者鼻部形态变化的疗效。
17例接受PNAM的新生儿UCLP患者在治疗开始时、初次鼻唇整形术前以及腭裂修复术前接受面部印模。对每个模型拍摄颏顶位照片，并通过数字摄影测量法进行分析。采用Wilcoxon检验和Friedman检验进行组内和组间比较。
PNAM治疗后，发现患侧鼻孔宽度有统计学意义的减小，健侧鼻孔宽度或总鼻宽无显著变化。患侧和健侧鼻孔高度显著增加，两侧鼻孔面积有不显著增加，鼻中隔有不显著的扶正。鼻唇整形术后，这些变化得以维持或进一步改善。
术前鼻牙槽塑形技术改善了南美洲单侧唇腭裂患者鼻唇整形术前鼻尖突出度和鼻翼软骨凹陷，并部分减少了鼻中隔偏曲。
