Three-dimensional longitudinal assessment of nasal development with and without Nasoalveolar molding therapy in cleft lip and palate patients.

Authors

Lucas M Ritschl, Klaudia Narbekovas, Denys J Loeffelbein, Alex Grabenhorst, Nils Krautkremer, Hannes Singer, Andrea Grandoch, Helena Kram, Klaus-Dietrich Wolff, Florian D Grill

Published in

Clinical oral investigations. Volume 29. Issue 10. Pages 487. Oct 03, 2025. Epub Oct 03, 2025.

Abstract

Grayson-type presurgical nasoalveolar molding (PNAM) is an established method in presurgical infant orthopedics. This study compared PNAM therapy with conventional palatal plates across cleft types, focusing on nasal morphology.
Seventy-two patients with non-syndromic unilateral (UCLP) and bilateral cleft lip and palate (BCLP) were followed from birth to two years. Three-dimensional (3D) models of the perinasal area were obtained via cast-based scans or 3D photographs; right-sided UCLP cases were mirrored to the left. Two independent reviewers analyzed anatomical landmarks with excellent inter-rater reliability (ICC = 0.88). Initial and two-year measurements were compared between PNAM (NAM group) and conventional treatment (non-NAM group).
Of the 72 patients, 46 had UCLP and 26 BCLP. In BCLP, NAM therapy promoted greater columella elongation from 2.1 mm at T₀ to 5.2 mm at T₃ compared to a change from 2.4 mm to 3.5 mm in the non-NAM group (p = 0.300). In UCLP, NAM was also associated with increases in columella (p = 0.387) and improved columella deviation angles, from a median of 48.1° at T₀ to 85.6° at T₃, while non-NAM showed a modest increase from 70.6° to 79.1°, (p = 0.167) Significant reductions were observed cleft-side nostril length (p = 0.027) and width (p = 0.029).
This study, using 3D imaging, demonstrates the clinically relevant capability of PNAM to improve nasal morphology compared to conventional treatment, potentially enhancing primary cheiloplasty outcomes. The longitudinal design three-dimensionally tracks preoperative and postoperative changes over two years, with further investigation needed for long-term stability.

PMID:
41042441
Bibliographic data and abstract were imported from PubMed on 03 Oct 2025.

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