Nasal Conformer Research Articles

Treatment Modalities to Achieve Nasal Symmetry in Unilateral Cleft Lip/Nasal Deformity: An Objective and Comparative Evaluation.

Primary cleft lip repair techniques do not address the nasal deformity adequately resulting in nasal asymmetry. Maneuvers employed to minimize this have varying degrees of success. To assess the outcome of different treatment modalities employed to establish nasal symmetry in unilateral cleft lip. 100 patients with complete unilateral cleft lip/ palate operated for primary cheiloplasty with modified Millard's rotation advancement technique were divided into five groups. Group 1: lip repair alone, Group 2: NAM followed by lip repair, Group 3: lip repair followed by placement of conformers, Group 4: NAM followed by lip repair and placement of conformers, Group 5: lip repair with semi-open rhinoplasty. Objective assessment was done using measurable parameters after 12months post-operatively on a 1:1 standard photograph. Group 5 showed statistical significance in all parameters assessed. Progressive improvement in nasal symmetry was noted from Group 1 to Group V. In our study, group V, i.e., modified Millard's repair with semi-open rhinoplasty improved the results in terms of all the objective parameters assessed. The results of the other groups showed improvement though not consistent in all parameters. Naso-alveolar molding is an effective adjunct. Additionally, nasal conformers proved to be of great value in retaining the results obtained post-surgery.

Scar folding for the treatment of nostril stenosis after open rhinoplasty: a case report

A 25-year-old woman was referred for discomfort when breathing through her left nose. The patient had undergone augmentation rhinoplasty 5 years ago, after which hypertrophic scarring occurred in the left nostril. Several corticosteroid injections were administered as the first line of treatment, but with no symptom improvement. Therefore, we proceeded with surgical scar removal, with the use of a nasal conformer. However, scarring in the left nostril recurred. Accordingly, we proceeded with further surgical treatment using the scar folding technique. After scar folding, neither scarring nor nostril stenosis recurred during 1 year of postoperative follow-up. To summarize, herein, we report a case of hypertrophic scarring in the nostril that was successfully treated with the scar folding technique.

Postoperative Nasal Conformers in Cleft Rhinoplasty: Are They Efficacious?

Lip and nose symmetry the goal of repair of unilateral cleft lip and different preoperative and postoperative treatments have been developed with this purpose. The objective of this study was to compare 2 techniques used for primary cleft lip nose repair. This is an retrospective study between 2 groups of patients with unilateral cleft lip and palate who underwent primary nasolabial repair either with or without postoperative nasal conformers. Data collection was accomplished by evaluation of nasal symmetry through anthropometric measurements under general anesthesia during primary cleft palate repair. Our comparative study did not find a statistically significant difference regarding percentile indexes of nasal asymmetry between the 2 groups. Major revision requirement (>3mm of asymmetry in any of the nose measurements) was observed in 3.84% of nasal conformer group and 4.65% of the group without nasal conformers. The results obtained from this study provides showed that placement of postoperative nasal conformers did not improve nasal symmetry in patients with unilateral cleft lip and palate. Based on these findings and available scientific evidence, definitive conclusions about the effectiveness of these devices on nasal symmetry after unilateral cleft lip nose repair cannot be drawn.

Post-surgical management of cleft lip and palate: Realization of nasal conformer

Background: the given important role of the post-surgical nasal conformer in the management of cleft lip and palate, the publication of this type of case reminds us of the multidisciplinary management of cleft lip and palate of newborns, and reminds us of the usefulness of having this type of device in the therapeutic arsenal even if surgical techniques have progressed. Case presentation: This is a newborn boy from northern Morocco who was diagnosed with a unilateral cleft lip and palate. He was first placed in an orthosis with a pre-surgical conformer on his second day of life. When he was four months, he then underwent corrective surgery in two stages: firstly, closure of the lip and nose, and secondly, closure of the alveolar region and the palate. For the conformer that interests us in this work, it was performed after three weeks of the first surgery, in order to have better results after the second surgery Conclusions: In summary, the presentation of this case shows us the importance of post-surgical conformers in the management of infants with cleft lip and palate and their ability to achieve better functional and aesthetic results for the patient without forgetting their psychological impact on the parents.

Custom-fabricated nasal conformers and surgical stents in the management of midfacial acid burn injuries: A clinical report

Acid burn injuries in the midfacial region cause contracture of the skin and nasal aperture, which can lead to nasal airway obstruction. Management of such complicated situations requires a multidisciplinary approach, including prosthetic intervention. This article describes a clinical treatment for fabricating a custom nasal conformer for a 28-year-old man who presented with a history of an acid burn injury leading to obstructed external nares and fusion of the tip and columella of the nose with the philtrum of the upper lip. The prosthesis served the dual function of maintaining the nasal airway passage and preventing the contracture of the graft placed over the upper lip during reconstructive surgery.

A Simple and Economical Nasal Conformer for Clefts!

To develop a nasal conformer for cleft lip repair which should be easily available and economical. We have used 'Luer mount' of the infant feeding tube as a nasal conformer in 14 patients. Follow-up period ranged from 2 weeks to 3 months. Results were satisfactory in all the patients. No significant complications were noticed in any of the patients. This nasal conformer is easy to use and cost-effective. Though it is not as soft as silicon-based nasal stent but, it provides good support for maintaining the shape of nasal cartilage.

Design and Manufacturing of Nasal Conformer

Cleft lip occurs due to incomplete joining of the tissue that forms the upper lip resulting in an opening in the upper lip. This opening is in the form of a slit and is large extending up to the nose. Many methods have been suggested in repairing the cleft lip. As a part of post-surgical treatment, the nasal deformity has been an issue. Nasal conformer is a post-surgical aid that helps the patients to keep their nasal deformity in control. The present work aims in design and manufacturing of this nasal conformer for the much needy poor patients. Computer Aided Design (CAD) techniques are used to model the nasal conformer by taking the dimensions of the various aged group people ranging from 6 months to 16 years old. Based on that, 5 such sizes have been arrived. These CAD models have been manufactured using Fused Deposition Modeling (FDM) technique to prepare the final pattern for molding process. Once the molds for the nasal conformer have been created, the final parts have been casted using Silicone material. The final casted nasal conformers are being proposed to be distributed to the needy.

An esthetic modification of a nasal conformer

Facial contractures caused by burns can collapse the nasal aperture and lead to airway obstruction. Management in such situations requires surgical and prosthetic intervention. Prosthetically, although a nasal conformer is the treatment of choice, even a well-fabricated nasal conformer may be esthetically unappealing and require an aid for enhanced retention. Expensive implant-aided conformers are not always a viable option. This article introduces a technique for fabricating a nasal conformer that is both esthetically appealing and cost-effective. The technique is illustrated by the treatment of a 12-year-old girl who presented with a history of burn injuries leading to nasal contracture that was effectively managed with this concept.

Use of Nasal Conformer After Birth Effectively Improves Nostril Symmetry in Patients With Unilateral Incomplete Cleft Lip

To investigate the clinical effects of preoperative nasoalveolar molding (NAM) and nasal conformer use in patients with unilateral incomplete cleft lip on the basis of their medical records and images. Data and images of 16 patients born with unilateral incomplete cleft lip who were hospitalized between January 2015 and August 2017 were retrieved from the medical records. The primary outcome was the extent of improvement in columella height (CH) before cheiloplasty. Other outcome measurements included the CH, nostril width, and nostril height, which were measured by ImageJ image processing software (version 1.4; National Institutes of Health, Bethesda, MD) and presented as ratios. Mann-Whitney U tests were used to compare the non-normally distributed data. Patients in the NAM group and those in the nasal conformer group showed significantly improved (P<.05) preoperative cleft-side CH-to-normal-side CH ratios compared with the corresponding ratios at birth. There was no significant difference in terms of the extent of improvement in CH between the groups. Preoperative use of nasal conformers in patients with unilateral incomplete cleft lip not only corrects the deformed nasal cartilage but also increases the CH and improves the overall preoperative nasal symmetry. In addition, compared with NAM, this method costs less, is more straightforward, and requires fewer outpatient clinic visits.

La septoplastie lors de la chéilorhinoplastie primaire dans les fentes labio-palatines unilatérales

Primary repair of cleft lip and palate has become a nasal and lip repair. In the aim to improve our nasal results on symmetry we perform an extensive septoplasty to put the nose in a good shape and a median axis. This septoplasty without resection of cartilage does not cause growth disorders to the nose and it promotes maxillary growth by improving early nasal breathing. It can prevent secondary rhinoplasty, source of new scars (externally, fork). But rhinoplasty will increase the incidence of scar contraction, thus shaping with a nasal conformer is essential.

The progressive changes of nasal symmetry and growth after nasoalveolar molding: a three-year follow-up study.

The purpose of this study was to assess the progressive changes of nasal symmetry, growth, and relapse after presurgical nasoalveolar molding and primary cheiloplasty in unilateral complete cleft lip/palate infants. Twenty-five consecutive complete unilateral cleft lip/palate infants were included. All the infants underwent nasoalveolar molding before primary cheiloplasty. Standard 1:1 ratio basilar photographs were taken before and after nasoalveolar molding, 1 week after cheiloplasty, and yearly for 3 years. Linear measurements were made directly on the photographs. The results of this study revealed that the nasal asymmetry was significantly improved after nasoalveolar molding and was further corrected to symmetry after primary cheiloplasty. After the primary cheiloplasty, the nasal asymmetry significantly relapsed in the first year postoperatively and then remained stable and well afterward. The relapse was the result of a significant differential growth between the cleft and noncleft sides in the first year postoperatively. To compensate for relapse and differential growth, the authors recommend (1) narrowing down the alveolar cleft as well as possible by nasoalveolar molding, (2) overcorrecting the nasal vertical dimension surgically, and (3) maintaining the surgical results using a nasal conformer.

Nasal conformer to restore facial contour

Surgical removal of the nose may have devastating psychologic effects on the patient. This article describes the fabrication and use of a nasal conformer to restore facial contour until a definitive nasal prosthesis can be made.