LAUSR

BACKGROUND The long-term effect of nasoalveolar molding (NAM) on patients with bilateral cleft lip and palate (BCLP) are unknown. We report clinical outcomes of facially-mature patients with complete BCLP who underwent NAM and gingivoperiosteoplasty (GPP). METHODS A single-institution retrospective study of non-syndromic patients with complete BCLP who underwent NAM between 1991-2000 was performed. All study patients were followed to skeletal maturity, at which time a lateral cephalogram was obtained. Total number of cleft operations and cephalometric parameters were compared to a previously published external cohort of patients with complete and incomplete BCLP in which a minority (16.7%) underwent presurgical orthopedics prior to cleft lip repair without GPP. RESULTS Twenty-four patients with BCLP comprised the study cohort. All patients underwent GPP, 13 (54.2%) underwent alveolar bone graft, and 9 (37.5%) required speech surgery. The median number of operations per patient was 5 [interquartile range (IQR) 2], compared to 8 (IQR 3) in the external cohort (p<0.001). Average age at the time of lateral cephalogram was 18.64 (1.92) years. There was no significant difference between our cohort and the external cohort with respect to SNA [73 °(6°) vs. 75°(11°), p=0.186] or SNB [78°(6°) vs. 74°(9°), p=0.574]. Median ANB was -3°(5°) compared to -1°(7°; p=0.024). Twenty patients (83.3%) underwent orthognathic surgery. CONCLUSIONS Patients with BCLP who underwent NAM and GPP were associated with significantly fewer total cleft operations and mixed midface growth outcomes at facial maturity compared to patients who did not undergo this treatment protocol.