"Accessible Presurgical Orthopedics: Nasal Elevator and Lip Taping as a Cost-Effective Solution for Cleft Care in Low-Resource Settings."

Abstract

Background: This study evaluates the use of a nasal elevator plus lip taping as an option for presurgical infant orthopedics (PSIO) in patients with complete unilateral cleft lip with or without cleft palate (CL±P).

Methods: From 2014 to 2019, 112 patients with unilateral CL±P underwent the studied presurgical treatment. Anthropometric measures from pre- and post-PSIO were compared within the treatment group. Postsurgical nasal morphology was compared to patients who did not receive presurgical treatment (N=62). The dental arch relationship for both groups was assessed using the 5-year-olds' index.

Results: The nostril width ratio and the columellar angle significantly improved after PSIO (p<0.001). Post-surgically, nasal asymmetry was observed in 20% of the treatment group compared to 59.7% in the control group (p<0.001). Dental arch relationship analysis in 78 patients showed no significant difference between the treatment and control groups (p=0.271 for CL+P, p=0.545 for CL-P).

Conclusions: Nasal elevator plus lip taping is an effective, reliable, and simple PSIO method. It is less invasive, easier for parents to manage, cost-effective, and allows for monthly follow-up by the surgeon. Thus, it provides an effective alternative for teams without access to Nasoalveolar Molding (NAM) therapy.