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

Abstract

Background: This study evaluated 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 before and after PSIO were compared within the treatment group. Postsurgical nasal morphology was compared with 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). After surgery, nasal asymmetry was observed in 20% of the treatment group compared with 59.7% of 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 cleft lip and alveolus; P = 0.545 for cleft lip and palate).

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 therapy.

Clinical question/level of evidence: Therapeutic, III.