الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 222 |  |  |
| | | from | 222 | | |
Abstract
Although the nasoalveolar molding (NAM) therapy has emerged two
decades ago in the management of UCLP as an early presurgical intervention;
there is a growing debate regarding its efficacy.
Systematic reviews and randomized controlled clinical trials (RCTs)
are both considered as the summit for the research to reach evidence.
Consequently, this study was designed as a prospective randomized controlled
clinical trial (RCT) controlling all the possible factors affecting the outcomes.
The evaluation was achieved on two phases:
Pre-surgical phase (RCT Phase-I), 3D quantitative maxillary geometric
analysis was performed for 3D laser scanned maxillary casts throughout the
presurgical period to assess the NAM efficacy regarding the maxillary
geometry and to concurrently analyze the maxillary changes without NAM in
the control cases. (Phase I- T0: before NAM, T1: after 1 month and T2:
before surgery).
Post-surgical phase (RCT Phase-II), nasal anthropometric analysis was
performed to assess the NAM efficacy regarding the achievement of the nasal
symmetry and compares it to that of the control and norms. (Phase II- T”0: 10
days after surgery, and T”1: 6 months after surgery).
The study presents a modified algorithm for the analysis of the 3D
maxillary geometric changes in UCLP infants. Moreover, the study proposes
a new algorithm using computer edit analysis to determine the main features
and metrics of the face defining the nose as an area of interest for assessment
of the nasal symmetry in UCLP infants.
Chapter-6 Summary and Conclusion
183
The main outcomes are; the significant decrease in the cleft gap, the
significant improvement in the midline deviation variables, the significant
improvement in the maxillary arch configuration, the increase in the middle
and posterior arch width with the insignificant decrease in anterior arch width,
and the insignificant decrease in the sagittal length of the greater segment
while the restriction of the vertical growth was demonstrated. Along with the
significant improvement in the nostril height symmetry, minimizing the
nostril inferior position asymmetry on the horizontal and vertical axes and the
nostril superior position asymmetry on the vertical axis only. The nostril
width ratio and nostril superior position were not significantly improved.
Based on the result of the study it was concluded that:
1- The NAM therapy efficiently improves the maxillary segments
geometrical alignment and configuration.
2- The NAM process in minimizing cleft gap severity does not come over
restriction to the transverse and sagittal maxillary growth.
3- The only limitation is the restriction to the vertical growth.
4- The NAM therapy efficiently achieves a maintained nasal symmetry.
5- Primary surgical repair alone is not efficient in achieving a maintained
nasal symmetry.
6- The NAM therapy can be efficiently used as a presurgical therapy for
improve the nasoalveolar deformity in UCLP infants.