Comparative Study of Early Secondary Nasal Revisions and Costs in Patients With Clefts Treated With and Without Nasoalveolar Molding

Patel, Parit A.; Rubin, Marcie S.; Clouston, Sean; Lalezaradeh, Frank; Brecht, Lawrence E.; Cutting, Court B.; Shetye, Pradip R.; Warren, Stephen M.; Grayson, Barry H.

doi:10.1097/scs.0000000000001729

Cited by 72 publications

(65 citation statements)

References 37 publications

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“…36–38 Long-term follow-up using these techniques has shown a decrease in secondary rhinoplasty and cleft lip revision rates, with resultant decreases in overall healthcare costs. 39 These finding again underscore the potential value of improving results during primary cleft lip and nasal repair.…”

Section: Introductionmentioning

confidence: 89%

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Hammoudeh

Imahiyerobo

Fan

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:The optimal timing for cleft lip repair has yet to be established. Advances in neonatal anesthesia, along with a growing body of literature, suggesting benefits of earlier cleft lip and nasal repair, have set the stage for a reexamination of current practices.Methods:In this prospective study, cleft lip and nasal repair occurred on average at 34.8 days (13–69 days). Nasal correction was achieved primarily through molding the nasal cartilage without the placement of nasal sutures at the time of repair. A standardized anesthetic protocol aimed at limiting neurotoxicity was utilized in all cases. Anesthetic and postoperative complications were assessed. A 3-dimensional nasal analysis compared pre- and postoperative nasal symmetry for unilateral clefts. Surveys assessed familial response to repair.Results:Thirty-two patients were included (27 unilateral and 5 bilateral clefts). In this study, the overall complication rate was 3.1%. Anthropometric measurements taken from 3-dimensional-image models showed statistically significant improvement in ratios of nostril height (preoperative mean, 0.59; postoperative mean, 0.80), nasal base width (preoperative mean, 1.96; postoperative mean, 1.12), columella length (preoperative mean, 0.62; postoperative mean, 0.89; and columella angle (preoperative mean, 30.73; postoperative mean, 9.1). Survey data indicated that families uniformly preferred earlier repair.Conclusions:We present evidence that early cleft lip and nasal repair can be performed safely and is effective at improving nasal symmetry without the placement of any nasal sutures. Utilization of this protocol has the potential to be a paradigm shift in the treatment of cleft lip and nasal deformity.

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Section: Introductionmentioning

confidence: 89%

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Hammoudeh

Imahiyerobo

Fan

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…Caregiver cooperation is most important in successful NAM outcome and despite difficulties most parents remain dedicated to NAM treatment . NAM does places a high burden of care on caregivers, on the other hand, substantial reduction in costs also result from NAM‐assisted primary surgery in comparison to other techniques …”

Section: Discussionmentioning

confidence: 99%

Initial experiences with NAM‐assisted primary repair of the BCLP deformity

Prasad

Ravindran

Radhakrishnan

et al. 2017

Special Care in Dentistry

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“…Moreover, it is expected a better cost-effectiveness potential with the use of this method in comparison to the treatment protocols without nasoalveolar molding (18).…”

Section: Discussionmentioning

confidence: 99%

Clinical application of customized presurgical nasoalveolar molding for the treatment of unilateral complete cleft lip and alveolus: case report

Premkumar

Tovani‐Palone

2018

Electron J Gen Med

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Cleft lip and/or palate (CL/P) are the most common craniofacial malformations in humans. The lip, alveolar ridge, palate and nose are areas frequently affected in people with this type of anomaly. Generally, there are also negative psychosocial impacts in children with these malformations. Moreover, a son with CL/P can become an emotional trauma to their parents. Multiple surgeries and other therapies are required for the treatment of most cases. During the first three months of life the surgical treatment of CL/P usually involves infant orthopaedics, such as presurgical nasoalveolar molding (PNAM), primary cleft lip repair and primary rhinoplasty. PNAM is a nonsurgical method, which has been used by many craniofacial centers. However, few reports concerning the customized use of PNAM for the treatment of complete cleft lip and alveolus have been described in the literature. In addition, the treatment success through this method has been a controversial subject. In this paper, we present the case of a newborn with unilateral complete cleft lip and alveolus treated with customized PNAM, based on the experience of the Tamil Nadu

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Comparative Study of Early Secondary Nasal Revisions and Costs in Patients With Clefts Treated With and Without Nasoalveolar Molding

Cited by 72 publications

References 37 publications

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol

Initial experiences with NAM‐assisted primary repair of the BCLP deformity

Clinical application of customized presurgical nasoalveolar molding for the treatment of unilateral complete cleft lip and alveolus: case report

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