Nose-Lip Morphology Changes after using Khon Kaen University Pre-Surgical Nasoalveolar Molding Device in Complete Unilateral Cleft Lip and Palate Patients by Measuring the Photographs
Thammapiwan A, DDS1, Pisek P, DDS, MSc, FRCDT, MOrthRCSEd, PhD1, Manosudprasit A, DDS DScD, CAGs1, Chowchuen B, MD, MBA2, Manosudprasit M, DDS, MDS, FRCDT1, Manosudprasit A, DDS, MSD, CAGs1
Affiliation : 1 Division of Orthodontic, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 2 Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Pre-surgical nasoalveolar molding (PNAM) device assists to approximate the normal anatomy of the nose and lip in
cleft lip and palate patients prior to cheiloplasty. In 2012, the Khon Kaen University pre-surgical nasoalveolar molding (KKU PNAM)
device was designed by dividing it into three parts: extraoral lip strapping, nasal molding device and intraoral active plate.
Objective : To evaluate changes to nose and lip morphology in the first two weeks, and post-application of the KKU PNAM device in
infants with complete unilateral cleft lip and palate (UCLP).
Materials and Methods: Fifteen UCLP infants were treated with the KKU PNAM device. Measurements from two-dimensional
photographs of the nose and upper lip on the cleft side were recorded at pre-treatment (T1), two weeks after the first visit (T2) and
before cheiloplasty (T3). The means and standard deviations (SD) were used as a descriptive statistic to explain the ratios and angles
values. Repeated one-way measures ANOVA was used to evaluate the statistical differences between the three groups.
Results : No significant difference to the ratio of the alar base width was reported. The ratio of nostril width at T1-T3 and T2-T3
decreased significantly. There were no changes to the ratio of nasal tip protrusion from the subnasaleat T2-T3. A statistically
significant decreased ratio of the alar base deviation, upper lip protrusion from the subnasale, vermillion gap and soft tissue gap was
found in T1-T2, T2-T3 and T1-T3. Moreover, the ratio of nostril height, the ratio of columella length, columella angle and nostril axis
inclination were increased significantly amid all points in time.
Conclusion : The application of the KKU PNAM device is a valuable procedure to improve nose and lip morphology in UCLP patients,
thereby enhancing the overall quality of surgical repair.
Keywords : Unilateral cleft lip and palate, Khon Kean University pre-surgical nasoalveolar molding device, KKU PNAM
