An assessment and comparison of nasolabial aesthetics in bilateral clefts using the anatomical subunit-based scale: a nasoalveolar moulding versus non-nasoalveolar moulding study

Bonanthaya, Krishnamurthy; Nayak, Tulasi; Bitra, S.; Rachwalski, Martin; Shetty, P.N.

doi:10.1016/j.ijom.2018.10.007

Cited by 6 publications

(9 citation statements)

References 18 publications

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“…The majority of papers (44/87, 50.6%) were confirmed to use unmodified Grayson-Santiago NAM or a minor variation that would be expected to perform similarly to unmodified Grayson-Santiago NAM according to the specific outcomes considered by this review. 20–50 Such acceptable variations included subtleties of device structure or minor changes to the timing of device modifications. 51–62 Many papers (28/87, 32.2%) did not specify the NAM technique that was employed and did not offer an adequate picture of the device or description of the protocol to be appraised.…”

Section: Results: Study Characteristicsmentioning

confidence: 99%

“…The most common comparator was non-treatment (ie, patients with CL ± A ± P who did not receive any NAM or PSIO). 24,26,30–34,36,38,62,65,67,69,76,79–84,88–90,92,94,95,100,101 The absence of NAM/PSIO was sometimes, but not always, compensated for by a different surgical technique or protocol. 35,57,85,100 The second most common comparator was age-matched, non-clefted children, as a representation of “normal” anatomy.…”

Section: Results: Study Characteristicsmentioning

confidence: 99%

“…Of these, 38 studies (62.3%) quantified this outcome using indirect anthromorphometry. 22–27,29,31,32,35,37,44,47,49,51–55,57–60,64,68,72,75,76,78,79,82,86–88,100,104–106 Indirect anthropometric measurements were taken from 2D photographs, 22–24,27,29,32,33,35,37,56–60,62,64,75,76,79,80,82,84,87–89,100,104,106 3D stereophotographs, 20,26,45,46,…”

Section: Results: Study Characteristicsmentioning

confidence: 99%

“…Of these, 38 studies (62.3%) quantified this outcome using indirect anthromorphometry. 22 Indirect anthropometric measurements were taken from 2D photographs, [22][23][24]27,29,32,33,35,37,[56][57][58][59][60]62,64,75,76,79,80,82,84,[87][88][89]100,104,106 3D stereophotographs, 20,26,45,46,65,72,77,78,86 nasal casts, 25,30,31,44,47,48(p199), 51,52,54,55,67,105 and 3D scans taken of the facial casts. 105 Few studies (4/61, 6.6%) reported direct anthromorphometry, measured directly from the patient's face while under anesthesia.…”

Section: Comparators or Controls Used For Outcomes Assessmentmentioning

confidence: 99%

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Systematic Review and Critical Appraisal of the Evidence Base for Nasoalveolar Molding (NAM)

Dunworth

Fimbres

Trotta

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective To critically appraise the body of scientific literature supporting the risks and efficacy of nasoalveolar molding (NAM), specifically in contrast to alternative methods of presurgical infant orthopedics (PSIO) or to treatment without PSIO. Main Outcome Measures Five outcome domains were considered: nasolabial aesthetics; dentoalveolar relationship; midfacial growth; cost and burden of care; and number of anesthetic events. Design MEDLINE, Embase, and Scopus were queried for articles from the first description of the Grayson-Santiago NAM technique (1993) through December 13, 2021. After the application of inclusionary and exclusionary criteria, selected articles were critically appraised using a systematic framework that included risk of bias assessment using the Cochrane RoB 2.0 and ROBINS-I tools. Results A total of 88 studies were included. Level-I and -II evidence showed on par or better approximation and alveolar alignment achieved by NAM compared to other PSIO. Level-II and -III evidence showed improved nasolabial aesthetics compared to other PSIOs. Level-II and -III evidence supported no harm to maxillofacial skeletal growth through age 12. Sparse level-III evidence supported a reduced number of labial or nasal revisions following NAM. Level-II and -III evidence showed NAM requiring upfront cost and frequent appointments but reducing caregiver psychosocial burden and reducing long-term costs compared to select alternatives. Many studies carried a high risk of bias. Conclusions Current evidence supports the overall efficacy of NAM regarding short/mid-term outcomes, with a low risk of negative effects on midfacial growth or dental development. The high risk of bias discovered in many papers underscores the need for robust study design in future research.

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Section: Results: Study Characteristicsmentioning

confidence: 99%

Section: Results: Study Characteristicsmentioning

confidence: 99%

Section: Results: Study Characteristicsmentioning

confidence: 99%

Section: Comparators or Controls Used For Outcomes Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Systematic Review and Critical Appraisal of the Evidence Base for Nasoalveolar Molding (NAM)

Dunworth

Fimbres

Trotta

et al. 2022

The Cleft Palate Craniofacial Journal

View full text Add to dashboard Cite

show abstract

“…Regretfully, being a retrospective evaluation, this study is unable to assess the advantages of NAM alone. The low incidence of BCLP makes it difficult, even in a relatively high-volume center, to properly randomize patients between those treated with the same columella lengthening surgical approach, with or without NAM, as larger centers, in other countries are starting to do (Bonanthaya et al, 2019). Intercenter studies could certainly help in increasing numbers, although surgeons’ experience and skill in nasal surgery might influence results so greatly, to render these comparisons just as biased.…”

Section: Discussionmentioning

confidence: 99%

Photometric Evaluation of Adult Patients With Bilateral Cleft Lip and Palate Treated With Nasoalveolar Molding and Primary Columella Lengthening

Meazzini

Parravicini

Donati

et al. 2021

The Cleft Palate Craniofacial Journal

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A short columella and a flattened nasal tip are the characteristic stigmata of patients with complete bilateral cleft lip and palate (BCLP). Objective: The aim of this study was to assess the nasal shape of young adults with BCLP treated with primary surgical columella lengthening and nasoalveolar molding (NAM). Setting and Patients: A group of 28 young adult patients with BCLP (mean age: 19.1±1.4 years) was compared through normalized photogrammetry to a control of 28 age- and sex-matched noncleft young adults. Results: Nasal protrusion and length of the columella were not different from noncleft young adults. On the other hand, nasolabial angle, columellar width, interalar, and nasal tip width were significantly wider than the noncleft controls. Thus, 27% of the patients have requested at this time secondary correction of the excessive nasal width. Conclusions: Both NAM and primary rhinoplasty in patients with BCLP resulted in a near normal length of the columella and nasal projection until young adulthood. Nevertheless, width of all nasal features was significantly wider than the noncleft population and required secondary nasal correction in one-third of the sample.

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Cleft Lip

Shetty

Chauhan²,

Patil

et al. 2021

Oral and Maxillofacial Surgery for the Clinician

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Many techniques exist at present for surgical repair of primary cleft lip. Since the introduction of Millard, most of the techniques are based on Millard’s Rotation advancement principle. However, every cleft surgeon aims to modify his/her technique to achieve optimum symmetry and function of the nose and lip. In this chapter, we have presented the principles of lip repair followed at our centre based on the very principles of Millard. We have also discussed embryology and anatomy from a surgical pint of view so as to understand the anatomic basis if cleft surgery.

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An assessment and comparison of nasolabial aesthetics in bilateral clefts using the anatomical subunit-based scale: a nasoalveolar moulding versus non-nasoalveolar moulding study

Cited by 6 publications

References 18 publications

Systematic Review and Critical Appraisal of the Evidence Base for Nasoalveolar Molding (NAM)

Systematic Review and Critical Appraisal of the Evidence Base for Nasoalveolar Molding (NAM)

Photometric Evaluation of Adult Patients With Bilateral Cleft Lip and Palate Treated With Nasoalveolar Molding and Primary Columella Lengthening

Cleft Lip

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