Impact of three types of presurgical infant orthopedics on nasolabial appearance in unilateral cleft lip and palate: a 4-year follow-up study.

OBJECTIVES

To evaluate the impact of presurgical infant orthopedics (PSIO) on nasolabial appearance among three PSIO methods (modified Grayson's technique, DynaCleft nasal elevator, OrthoAligner NAM with DynaCleft nasal elevator) and no-PSIO in children with unilateral cleft lip and palate (UCLP) at 4 years' follow-up.

MATERIALS AND

METHODS

This study took place in an academic and a peripheral center at which patients with UCLP were treated and followed. A total of 48 patients with UCLP were divided into four groups of 12 patients each. Group 1 underwent PSIO using modified Grayson's technique. Group 2 received PSIO incorporating DynaCleft nasal elevator. Group 3 treatment involved OrthoAligner NAM in combination with DynaCleft nasal elevator, whereas Group 4 did not receive any form of PSIO. Asher-McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS) were used to assess nasolabial appearance 4 years post-lip surgery (mean age: 4.3 years ± 6 months) on standardized photographs of the nasolabial region. Kruskal-Wallis test was used to assess nasolabial appearance scores among treatment groups.

RESULTS

Nasolabial appearance showed no significant differences between PSIO and no-PSIO groups across facial esthetic indices regarding nasal form (P = .819), deviation of the nose (P = .403), shape of the vermillion border (P = .801), nasal profile including upper lip (P = .726), nose (P = .973), and lips (P = .72).

CONCLUSIONS

In patients with UCLP, there was no significant difference in nasolabial appearance 4 years after lip repair when comparing three different PSIO modalities to no-PSIO group.