Comparison of Early Onset Nasoalveolar Molding With Patients Who Presented for Molding Up to 1 Year of Age

Shetty, Vikram; Thakral, Ankur; Sreekumar, Chandni

doi:10.1016/j.joms.2015.08.004

Cited by 26 publications

(22 citation statements)

References 21 publications

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“…Matsuo reported that delay in NAM treatment might influence outcome due to decreasing plasticity in the nasal cartilage as the infants age 26 . Shetty concluded most of the benefit of NAM is obtained when NAM is applied before 1 month of age 12 . In our study the three patients over a month in age at time of commencing therapy eventually obtained equally good outcome as the other children who had earlier initiation.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to our progressive analysis with dense sampling, most of the literature compares only the pre- and post-NAM morphologies 9 , 10 , 12 , 27 . Our study demonstrates the tempo and degree of progressive changes in nasal symmetry, and was able to document complete nasal correction or even overcorrection prior to primary lip repair.…”

Section: Discussionmentioning

confidence: 99%

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The role of Nasoalveolar molding: A 3D Prospective analysis

Chou

Hallac

Ajiwe³

et al. 2017

Sci Rep

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Nasoalveolar molding (NAM) is commonly employed to reduce the alveolar segments into proper alignment and to improve nasal symmetry in patients with cleft lip and palate. This study examines the periodical progression of NAM treatment over time. 20 patients with complete unilateral cleft lip and palate were prospectively recruited. A 2 stage NAM treatment protocol was applied. Stage 1 involved adjustment of the alveolar segments (mean age 15.6 days), while Stage 2 added nasal stents and started average 43 days after stage 1. 3D images (n = 241) were obtained prior to NAM initiation and weekly until the end of treatment. The cleft lip area, bilateral nostril areas, and the nostril height and width were measured. Treatment was assessed in the Cleft (C) side and the Non-cleft (N). There was significant difference in the C/N ratio of the nostril area, width, and height at pre-treatment (0.9 ± 0.3, 4.1 ± 1.1, and 0.5 ± 0.2), at the end of stage 1 (1.1 ± 0.3, 2.2 ± 0.6, and 0.8 ± 0.2), and at the end of stage 2 treatment (1.8 ± 0.3, 1.8 ± 0.4, and 1.2 ± 0.1); p < 0.05. Comparative 3D analysis with dense sampling offers a precise methodology for showing effects of NAM treatment. The morphological changes achieved with NAM therapy occur in early treatment phase.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of Nasoalveolar molding: A 3D Prospective analysis

Chou

Hallac

Ajiwe³

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Similarly, Nazarian Mobin et al (2011) recognized the challenges experienced in their study, noting mild tape irritation, financial and compliance-related issues without quantifying these factors. Meanwhile, 2 articles by Shetty et al reported high parent and patient compliance without loss to follow-up (Shetty et al, 2012; Shetty et al, 2016). Chang et al (2018) noted that the parents of 24 of 36 patients opted not to pursue NAM due to feeding, cost, skin irritation, and travel concerns, while Zuhaib et al (2016) noted that 17% of those who did agree to NAM in their cohort did not complete therapy.…”

Section: Resultsmentioning

confidence: 99%

What Is the Burden of Care of Nasoalveolar Molding?

Alfonso

Ramly

Kantar

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: This systematic review aims to evaluate nasoalveolar molding (NAM) in the context of burden of care defined as physical, psychosocial, or financial burden on caregivers. Search Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 5 databases were searched from inception through December 24, 2019, for keywords and subject headings pertaining to cleft lip and/or palate and NAM. Eligibility Criteria: Clinical studies on NAM with reference to physical (access to care, number of visits, distance traveled), psychosocial (caregiver perceptions, family interactions, breast milk feeding), and financial (direct and indirect costs) burden were included. Data Collection and Analysis: Study selection was performed by 2 independent reviewers. Results: The search identified 1107 articles and 114 articles remained for qualitative synthesis. Burden of care domains were discussed but not measured in 43% of articles and only 25% assessed burden of care through a primary outcome. Of these, 20 articles reported on physical, 8 articles on psychosocial, and 12 articles on financial burden. Quality of evidence is limited by study design and risk of bias. Conclusion: Nasoalveolar molding has been indiscriminately associated with burden of care in the literature. Although NAM may not be the ideal treatment option for all patients and families, the physical considerations are limited when accounting for the observed psychosocial advantages. Financial burden appears to be offset, but further research is required. Teams should directly assess the impact of this early intervention on the well-being of caregivers and advance strategies that improve access to care.

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“…Results presented by Shetty et al [ 51 ], highlighted that a treatment started prior to one month of age has a greater impact on the nasal symmetry than treatments started after this period. In another study by Shetty et al [ 52 ], are comparing the patients that initiate the treatment before 1 month, between 1 and 6 months and patients that started NAM after 6 months. It showed that beneficial NAM outcomes are increased if the treatment is started as soon as possible.…”

Section: Resultsmentioning

confidence: 99%

Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review

Maillard

Retrouvey

Ahmed

et al. 2017

JOMR

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ObjectivesThe authors performed a systematic review to evaluate the potential beneficial effects of the nasoalveolar molding appliance on nonsyndromic unilateral clefts of the lip and/or palate prior to primary lip repair.Material and MethodsA literature search was performed using three electronic databases (PubMed, Embase, Web of Science) and three journals (“Cleft Palate-Craniofacial Journal”, “Plastic and Reconstructive Surgery Journal” and “American Journal of Orthodontics and Dentofacial Orthopaedic”) from January 1980 to April 2017. Data extraction was performed with tables treating different subjects: surgical, aesthetical, functional, socio-economical effects of nasoalveolar molding (NAM) appliances and the evolution of NAM appliances, especially three-dimensional technology.ResultsOf the 145 articles retrieved in the literature surveys, 28 were qualified for the final analysis and 20 studies were excluded because of their small sample size (less than 10 patients) and/or too long follow-up (exceeded 18 months). Four randomized controlled trials were available. Although literature allowed discussing the short-term benefits of NAM appliance and the three-dimensional technology, scientific evidence is lacking.ConclusionsBased on the results, nasoalveolar molding appliances have positive surgical, aesthetical, functional and socio-economical effects on unilateral clefts of the lip and/or palate treatment before the primary repair surgeries. Three-dimensional technology results in a more efficient and predictable nasoalveolar molding appliance treatment. However, nasoalveolar molding appliance effect in a short term remains unclear with the available literature. Further studies that integrate three-dimensional technology in a large scale are still needed.

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Comparison of Early Onset Nasoalveolar Molding With Patients Who Presented for Molding Up to 1 Year of Age

Cited by 26 publications

References 21 publications

The role of Nasoalveolar molding: A 3D Prospective analysis

The role of Nasoalveolar molding: A 3D Prospective analysis

What Is the Burden of Care of Nasoalveolar Molding?

Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review

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