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Scholars Journal of Dental Sciences | Volume-7 | Issue-09
Modified Presurgical NAM: A Comparative Clinical Evaluation in Complete Unilateral Cleft Lip and Palate Management
Dr. Alka Rani, Dr. Seema Thakur, Dr. Devashish, Dr. Vijay Kumar Diwana, Dr. Tripti Chauhan, Dr. Kapil Dev Sharma
Published: Sept. 28, 2020 | 139 83
DOI: 10.36347/sjds.2020.v07i09.005
Pages: 127-132
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Abstract
Background: Cleft lip and palate deformity presents one, of the most complex surgical challenges. Although surgical correction remains the cornerstone of treating this deformity, some inadequacies still remains. Presurgical-Nasoalveolar molding (PNAM) is used as an adjunct to reduce and reshaping the alveolar and nasal defect. In the original Grayson’s technique has some limitations such as frequent appointment and recall, and ulcerations so Figueroa modified PNAM technique (less researched) was selected for PNAM in the present study as it allows nasal and alveolar moulding at the same time thereby reducing the requirement of appointments for adjustments. Aim: To evaluate the effectiveness of Figueroa modified PNAM as a method of improving nasal symmetry and alveolar cleft in patients with UCLP (Unilateral Cleft Lip and Palate). Materials and Methods: Total number of Thirty (n=30) children of less than one year of age, with cleft lip and palate were selected for the study. These were equally divided into 2 groups, group I treated with PNAM appliance, using Figueroa modified PNAM technique & followed by surgical lip repair and group II (control group) where primary cheilioplasty was carried out without PNAM. These patients were evaluated at various intervals and compared for various alveolar and nasal parameters, (nostril height, nostril width, columellar height, Bi-alar width and Intersegment distance. Data obtained from comparison of the groups were analyzed using-test. Results: A significant improvement of nasal symmetry and reduction of alveolar cleft gap on the cleft side in the PNAM group was observed in the PNAM group as compared to the control group. Conclusion: The Figueroa modified PNAM technique is efficient, cost effective and less tedious, that can reduce the number of future secondary surgeries. Studies with wider patient base, randomization and longer follow-ups are needed for definitive results.