# A survey on nasoalveolar moulding treatment practices at cleft centres across India

## TL;DR

This survey explores how cleft centers in India use nasoalveolar moulding (NAM) to treat cleft lip and palate, highlighting common practices and challenges.

## Contribution

The study provides a comprehensive overview of NAM treatment practices across Indian cleft centers, revealing variations in implementation and perceived benefits.

## Key findings

- 85% of cleft teams offer NAM before lip surgery, but only 28% treat more than 50% of their patients.
- Grayson's method is the most commonly used NAM technique, with consensus on its benefits for unilateral and bilateral clefts.
- Cheek and mucosal irritation are the most frequently reported side effects, though all respondents would recommend NAM.

## Abstract

The purpose of this study is to assess the current protocols followed in the practice of NAM treatment for patients with cleft lip and palate across different comprehensive centres in India.

Cross sectional questionnaire based study.

Comprehensive cleft teams across India were invited to participate in this survey. The questionnaire was developed over four stages, with a panel of eight members. The developed questionnaire consisted of 29 questions that included demographic details, decision-making process, treatment protocols, experiences with treating patients, difficulties and complications encountered during treatment. The results were reported descriptively in percentages.

Of the 46 teams, 39 teams (85%) reported offering NAM before lip surgery, while 15% (n = 7) teams did not offer NAM. Of these 39 teams, almost half (49%, n = 19) of the teams were providing NAM to less than 20% of their patients, 28% (n = 11) of the teams were providing treatment to more than 50%, and the remaining respondents reported (23%, n = 9) providing NAM to 21%–50% of their patients. There is a consensus that NAM is beneficial for both unilateral and bilateral clefts, with the Grayson's method as the most commonly used technique. While there is general agreement on their effectiveness, 15% of participants were unsure. The most frequently reported side effects were cheek and mucosal irritation. Despite these issues, all respondents would recommend NAM treatment.

The survey demonstrated a strong consensus among centers regarding most aspects of NAM treatment. Notably, all respondents expressed their willingness to recommend NAM to their friends and family.