Clinical Outcomes of Nasoalveolar Moulding in Bilateral Cleft Lip and Palate

Abstract

Introduction: Nasoalveolar Moulding (NAM) is a pre-surgical technique designed to reshape the alveolus, lip, and nose in infants with cleft lip and palate. The objectives of NAM for bilateral cleft lip and palate include: retracting the premaxilla using extraoral traction via lip taping, preserving the arch form with a passive appliance, developing clinically significant columellar tissue, and achieving harmonious nasal tip projection. Aim and Objective: To access effectiveness of nasoalveolar moulding on alveolus and nose in bilateral cleft lip and palate. Study Design: Descriptive study. Place and Duration of Study: IGIMS, Patna. Between March 2022 and March 2024. Material and Method: This descriptive study comprised 10 infants with bilateral cleft lip and palate (BCLP), undergoing nasoalveolar moulding (NAM).  The mean age of the infants at the start of the study was <6 weeks, impression was taken over which NAM appliance was fabricated and adjusted weekly depending upon progress of the treatment. Nasal stents were incorporated once the cleft width was reduced to 6 mm. Duration of treatment extends to 25 to 29 weeks. Post NAM impression was taken, alveolar and nasal measurements were recorded. Result: Right & left Alveolar cleft width, mid-palatal arch width decreases significantly. Columellar length, right & left nasal height increase due to tissue elongation. Right & left nasal width and bialar width decreases significantly. Conclusion: NAM therapy should be considered an integral part of the multidisciplinary approach to managing cleft lip and palate, improving not only the surgical outcomes but also the overall quality of life for affected infants.