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Nasoalveolar molding Rate of Change in Bilateral Cleft Lip and Palate

Lucas M. Harrison,Kayla Prezelski,R. Hallac,James R. Seaward,Alex A. Kane,Y. Park

Published 2025 in FACE

ABSTRACT

Objective: Nasoalveolar molding (NAM) in bilateral cleft lip and palate (BCLP) patients has been shown to improve anatomical alignment and assist in primary cleft lip and nasal repair. However, the rate of change throughout the treatment period and how the length of treatment time impacts outcomes have yet to be elucidated. This study aims to assess the progressive changes in the lips and nose during NAM therapy in patients with BCLP. Design: A retrospective review of 165 three-dimensional (3D) images of BCLP patients who underwent NAM. 3D images were obtained pre-NAM and weekly over the 10 weeks of NAM therapy. Setting: Tertiary pediatric hospital. Patients, Participants: 15 patients with BCLP who underwent NAM. Main Outcome Measures: Nostril height and width, lip gap, columella height, prolabium height, and nasion–prolabium–chin angle. Results: The lip gap consistently decreased over time, with R2 equal to .858. The prolabium height had limited change over time with a consistent increase in the nasion-prolabium-chin angle with R2 equal to .664. The nostril and columella heights consistently increased over time, with R2 equal to .792 and .866, respectively. Limited change was seen in nostril width. Conclusions: The consistent rate of change indicates that an increased treatment period would result in decreased lip gap with the posterior movement of the prolabium and an increase in the nostril and columella height. The benefits of an increased treatment period with NAM must be weighed against the hindrance of delaying primary surgical repair and the cost burden to patients’ families.

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