A Comparative Evaluation of Presurgical Infant Orthopaedics of Modified Grayson's Technique With Rhinoplasty Appliance System in Patients With Unilateral Cleft Lip and Palate

Objective: To evaluate the effects of presurgical infant orthopaedics using the Modified Grayson technique and Rhinoplasty Appliance System on the maxillary alveolus and nasolabial region in infants with unilateral cleft lip and palate (UCLP).

Materials and methods: This prospective study looked at 26 patients with a mean age of 6.3 ± 1.48 days, having complete UCLP. The study sample was divided into two groups of 13 UCLP infants: Group 1, treated by the modified Grayson technique, and Group 2, treated with the Rhinoplasty Appliance System (RAS). The scanned cast parameters were assessed before and after PSIO treatment, assessing treatment changes in the alveolar arch, which was further supplemented with standardised anteroposterior, Worms-eye view and profile photographs assessing sift tissue facial parameters. Descriptive statistics were applied, and a two-tailed t-test for intergroup comparison was used to determine cast and facial parameters across the two techniques.

Results: Intra-group assessment of cast and facial parameters showed a significant difference (p < 0.005) across pre and post-treatment assessment using two different treatment modalities. However, intergroup comparison showed no significant difference (p > 0.005) between modified Grayson's and RAS techniques.

Conclusion: In infants with UCLP, both techniques significantly impacted the alveolus and nasolabial region while reducing cleft defects. However, an intergroup comparison of both the treatment modalities showed similar effects on intraoral and extraoral parameters. Integrating RAS into PSIO protocols shows promise in treating lip-and-palate cleft deformities. The study emphasises the value of digital technology in enhancing PSIO protocols, with potential benefits for treatment standardisation and improvement in patient experience.