Nasolabial morphological changes in patients with unilateral cleft lip and palate using a Korat‐modified nasoalveolar moulding appliance with primary correction

• Published in: Orthodontics & craniofacial research Vol. 27; no. S1; pp. 80 - 89
• Main Authors: Nirunrungrueng, Pinai, Virarat, Pongjai, Techalertpaisarn, Paiboon, Ungvijanpunya, Nicha
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2024
• Subjects: cheiloplasty; Child; Cleft Lip - pathology; Cleft Lip - surgery; cleft lip and palate; Cleft lip/palate; Cleft Palate - pathology; Cleft Palate - surgery; Female; Humans; Infant; Lip - pathology; Longitudinal Studies; Male; Morphology; Nasoalveolar Molding; nasoalveolar moulding; Nose; Nose - pathology; Palatal Obturators; pre‐surgical orthopaedics; rhinoplasty; Rhinoplasty - methods; cheiloplasty; nasoalveolar moulding; pre‐surgical orthopaedics; cleft lip and palate; rhinoplasty
• ISSN: 1601-6335; 1601-6343; 1601-6343
• DOI: 10.1111/ocr.12765

Objective The objective of this study is to measure the morphological changes of the nose and lip in patients with unilateral cleft lip and palate before and after cheiloplasty with primary rhinoplasty (primary correction) in conjunction with Korat‐NAM usage. Design Longitudinal cohort study. Setting Cleft Center Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand. Subjects Twenty‐six patients with unilateral cleft lip and palate. Interventions Control group: only active obturator before primary correction. Experimental group: an active obturator and Korat‐NAM I before primary correction. A customized endotracheal tube was retained in the nostril for 3 weeks before switching to Korat‐NAM II for 1 year. Main Outcome Measures Six measurements comprising nostril rim length, nostril height, nostril sill width, columella angle, vertical lip height, and horizontal lip length were measured from the patients' photographs. All measurements, except the columella angle, were reported as the cleft side/non‐cleft side value ratio. Measurements were taken at the initial appointment, immediately before, 3 weeks after, and 1 year after primary correction. Results Nostril rim length ratio, nostril height ratio, nostril sill width ratio, columella angle on the cleft side, and vertical lip height ratio were improved using Korat‐NAM before and 3 weeks after primary correction. Nostril rim length and height ratios were significantly better than the control group. Conclusions Korat‐NAM improved nose and lip morphology before primary correction. An overcorrection improved the nose and lip morphology on the cleft side. The nostril rim length and vertical lip height on the cleft side also improved with Korat‐NAM II 1 year after primary correction.