Normative Palatal Measurements in Infants: Implications for Nasoalveolar Molding in Cleft Lip and Palate Patients

Katherine A Gossett; Serena N Kassam; Tyler M Rist; Jenna Thuman; Seth Stalcup; Milad Yazdani; Mathew J Gregoski; Krishna G Patel

doi:10.1097/SCS.0000000000011039

Normative Palatal Measurements in Infants: Implications for Nasoalveolar Molding in Cleft Lip and Palate Patients

J Craniofac Surg. 2025 Jan 6. doi: 10.1097/SCS.0000000000011039. Online ahead of print.

Authors

Katherine A Gossett¹, Serena N Kassam², Tyler M Rist³, Jenna Thuman⁴, Seth Stalcup⁵, Milad Yazdani⁵, Mathew J Gregoski⁶, Krishna G Patel³

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Wake Forest University School of Medicine, Winston Salem, NC.
² Department of Pediatric Dentistry, New York University, New York, NY.
³ Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina.
⁴ Department of Plastic Surgery, Medical University of South Carolina.
⁵ Department of Neuroradiology, Medical University of South Carolina.
⁶ Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.

PMID: 39760609
DOI: 10.1097/SCS.0000000000011039

Abstract

Background: Children with cleft lip ± palate (CL/P) may undergo nasoalveolar molding (NAM) before surgery to achieve arch alignment and tension-free closure, yet the endpoint of arch dimensions has not been defined.

Objective: To characterize the size and shape of infant palates using anatomic landmarks on magnetic resonance imaging in infants without CL/P.

Methods: Magnetic resonance imaging of infants without cleft palate younger than 3 months were reviewed and 13 measurements were taken to define palatal shape: distance between incisive foramen (IF) and incisors (IN), IF and middle of canines (MOC), between MOCs, between first molars (FM), 2 depth and 4 angle measurements.

Results: Ninety-two infants between 30 and 44 weeks old were included. Pre-maxillary growth from 30 to 44 weeks demonstrated the slowest growth (0.06 cm) from IF to between IN (B) and the greatest growth (0.7 cm) between the width of FM (K). The measurements between MOC (J) and between FMs (K) had the highest positive correlation to age at 0.55 and 0.61, respectively.

Conclusion: There was predictable growth of the palate noted between 30 and 44 weeks, with the most predictive measurements represented by the width of the canines and first molar locations along the alveolus. These values can help guide pre-surgical orthopedics in infants with CL/P.