Efficacy of Noordhoff surgery combined with PNAM orthodontics for children with cleft lip and palate

doi:10.19438/j.cjoms.2020.04.013

Abstract

Abstract: PURPOSE: To investigate the efficacy and safety of Noordhoff surgery combined with presurgical nasoalveolar molding (PNAM) orthodontics for children with cleft lip and palate (CLP). METHODS: The clinical data of 80 CLP children admitted to Luohe Central Hospital and The First Affiliated Hospital of Zhengzhou University from July 2014 to January 2019 were reviewed and analyzed. The children were divided into two groups according to different treatment methods. Patients in the combined group (n=61) received Noordhoff surgery combined with PNAM orthodontics, while patients in Noordhoff group (n=19) received Noordhoff surgery alone. The efficacy and safety of the two groups were compared. SPSS 19.0 software package was used for data analysis. RESULTS: The operation time of the combined group was significantly shorter than that of the Noordhoff group, and the intraoperative blood loss was significantly less than that of the Noordhoff group (P<0.05). There was no significant difference in surgical complications between the two groups (P>0.05). During the orthodontic treatment of PNAM in the combined group, mucosal ulcer and bleeding symptoms in the soft palate, maxillary nodule and lining mucosa of the affected side were observed in 18 cases, and contact rash at the adhesion of waterproof adhesive tape on bilateral buccal skin was observed in 42 cases. The height of the lateral lip, the length of the healthy lip and the length of the affected lip were significantly increased in the two groups 3 months after operation (P<0.05), and significantly higher in combined group than in the Noordhoff group (P<0.05). The width of the affected nostrils was decreased in both groups after treatment (P<0.05), and were significantly lower in the combined group than in Noordhoff group(P<0.05). BK horizontal distance, BK sagittal line distance, sagittal line length and MG sagittal line distance were significantly decreased in both groups 3 months after operation (P<0.05), and significantly lower in the combined group than in Noordhoff group (P<0.05). J-(F-G) was increased in both groups after treatment (P<0.05), while no significant difference was found between the two groups 3 months after treatment(P>0.05). CONCLUSIONS: PNAM orthodontic treatment before Noordhoff surgery can effectively alleviate operation difficulty and shorten operation time, with less intraoperative blood loss and better nasolabial morphology; however, there are many complications during the treatment of PNAM. It is recommended that the area of pain and ulcers be fully lubricated and polished during the correction process, and the number of waterproof tape replacements should be reduced to alleviate the pain of the child.

Key words: Noordhoff surgery, PNAM orthodontics, Cleft lip and palate

CLC Number:

R782.2

ZHANG Xiao-min, YANG Ya-xian, ZONG Yuan, LIN Ming. Efficacy of Noordhoff surgery combined with PNAM orthodontics for children with cleft lip and palate[J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(4): 352-356.

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