“The Surgical Nasoalveolar Molding (SNAM) for Unilateral Cleft Lip Nose and Palate Repair”

BACKGROUND: Cleft lip and palate is a highly prevalent birth defect affecting the upper lip and palate both aesthetically and functionally. Different techniques have been described throughout history, and during the last decades, pre- and postsurgical treatments have been added. The aim of this study is to evaluate the impact of the surgical treatment based on the surgical nasoalveolar molding method. METHODS: A comparative cohort study has been done in 45 unilateral cleft lip and palate patients treated with 2 surgical techniques based on the surgical nasoalveolar molding principle and operated on by the author. The techniques used were V-Y-Z vestibular advance (group A), and the nasal vestibule Z plasty (group B), and no type of presurgical management was performed for any of the studied patients. Postoperative outcomes have been evaluated according to the nasal symmetry degree determined through anthropometric measurements, as well as the postoperative complications report. RESULTS: During the follow-up, we observed 33% of nostril symmetry in group A and 37.5% in group B, which was not statistically significant. Major nasal revision was indicated in 9.5% (group A) and 8.3% (group B) without statistically significant differences between them. The number of associated postoperative complications was higher in group A. CONCLUSIONS: Surgical techniques based on the surgical nasoalveolar molding principle proposed by the author are an alternative for the treatment of the nasal deformity associated with the unilateral cleft lip and palate. These results should be confirmed with a longer follow-up period and experimental studies. LEVEL OF EVIDENCE: Level IV.