Analytical Imaging and Modeling Center, Children's Health, Dallas, Texas, United States.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Sci Rep. 2017 Aug 29;7(1):9901. doi: 10.1038/s41598-017-10435-6.
Nasoalveolar molding (NAM) is commonly employed to reduce the alveolar segments into proper alignment and to improve nasal symmetry in patients with cleft lip and palate. This study examines the periodical progression of NAM treatment over time. 20 patients with complete unilateral cleft lip and palate were prospectively recruited. A 2 stage NAM treatment protocol was applied. Stage 1 involved adjustment of the alveolar segments (mean age 15.6 days), while Stage 2 added nasal stents and started average 43 days after stage 1. 3D images (n = 241) were obtained prior to NAM initiation and weekly until the end of treatment. The cleft lip area, bilateral nostril areas, and the nostril height and width were measured. Treatment was assessed in the Cleft (C) side and the Non-cleft (N). There was significant difference in the C/N ratio of the nostril area, width, and height at pre-treatment (0.9 ± 0.3, 4.1 ± 1.1, and 0.5 ± 0.2), at the end of stage 1 (1.1 ± 0.3, 2.2 ± 0.6, and 0.8 ± 0.2), and at the end of stage 2 treatment (1.8 ± 0.3, 1.8 ± 0.4, and 1.2 ± 0.1); p < 0.05. Comparative 3D analysis with dense sampling offers a precise methodology for showing effects of NAM treatment. The morphological changes achieved with NAM therapy occur in early treatment phase.
鼻腔整形术（NAM）常用于将牙槽段恢复到适当的对齐位置，并改善唇腭裂患者的鼻对称性。本研究考察了 NAM 治疗的时间进程。前瞻性招募了 20 例完全单侧唇腭裂患者。应用两阶段 NAM 治疗方案。第一阶段涉及牙槽段的调整（平均年龄 15.6 天），第二阶段在第一阶段结束后平均 43 天添加鼻支架。在 NAM 开始前和每周治疗结束前获得 3D 图像（n=241）。测量了裂隙唇区域、双侧鼻孔区域以及鼻孔高度和宽度。在裂隙（C）侧和非裂隙（N）侧评估治疗效果。治疗前（0.9±0.3、4.1±1.1 和 0.5±0.2）、第一阶段结束时（1.1±0.3、2.2±0.6 和 0.8±0.2）和第二阶段结束时（1.8±0.3、1.8±0.4 和 1.2±0.1），C/N 比值的鼻孔区域、宽度和高度均有显著差异；p<0.05。密集采样的比较 3D 分析提供了一种精确的方法来显示 NAM 治疗的效果。NAM 治疗所实现的形态变化发生在早期治疗阶段。
