Is Presurgical Nasoalveolar Molding Therapy More Effective in Unilateral or Bilateral Cleft Lip–Cleft Palate Patients?

Mobin, Sheila S. Nazarian; Karatsonyi, Ashley; Vidar, Evan N.; Gamer, Simon; Groper, J N; Hammoudeh, Jeffrey A.; Urata, Mark M.

doi:10.1097/prs.0b013e318205f3ac

Cited by 31 publications

(19 citation statements)

References 12 publications

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“…18,19,36,42 NAM has shown us that targeted forces applied to the nasal cartilage during the neonatal period can lead to a normalization of the nasal anatomy. 42 This study does not call into question NAM’s efficacy; however, this efficacy is reliant on compliance with a strict follow-up schedule, which is not practical in all instances. Therefore, in this study, patients who had undergone NAM were excluded from the study population.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…, Nazarian Mobin et al . , Simanca et al . , Abbot & Meara ) – even in the long term (Barillas et al .…”

Section: Introductionmentioning

confidence: 99%

Parental experience caring for cleft lip and palate infants with nasoalveolar moulding

Hopkins

Gazza

Marazita³

2016

Journal of Advanced Nursing

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“…The presurgical nasoalveolar molding (NAM) technique proposed by Grayson 6 has been gaining popularity over the last two decades due to its utility in reducing the severity of the of clefts in early infancy. 7 Although multiple short-term studies, [8][9][10][11][12] have shown an increase in the columella length, molding of the deformed nasal cartilages, and obtaining arch approximation, the retention of the results obtained have not been conclusively established. 1 We have conducted this longitudinal study to ascertain the 5-year stability of the nasal symmetry achieved by NAM in unilateral cleft lip and palate (UCLP) patients.…”

Section: Introductionmentioning

confidence: 99%

A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

Nayak

Parmar

Bonanthaya

et al. 2020

Indian J Plast Surg

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Background Nasoalveolar molding (NAM) has been extensively used as a presurgical technique in the treatment of unilateral cleft lip and palate (UCLP) over the last two decades. It has proven to be a useful tool to reduce the cleft size, improve nasal symmetry, and increase the columellar length. The long-term stability of these findings has not been conclusively proven. Methods In this longitudinal study, the nasal symmetry of 24 NAM treated UCLP patients was evaluated to assess the 5-year stability of NAM. The basal photographs were shot postcheiloplasty (T1), at 1-year follow-up (T2), at 3-year follow-up (T3), and 5-year follow-up (T4) appointments. Results In this study, we found that NAM was a useful adjuvant in achieving nasal symmetry in patients with UCLP in the immediate postoperative period. However, as the patients aged, there was a gradual loss of mean nasal height (by 22.83%) and columella length (by 24.89%), a mean gain in nasal width (by 40.25%) and alar base width (by 40.69%), and an increase in the columella deviation (by 3.46%) from the T1 to the T4 follow-up. Conclusion Although there is no conclusive evidence, the loss of symmetry may be due to the unequal growth on the cleft and noncleft sides. These patients will be followed-up till end of growth for a definite conclusion on the long-term effect of NAM.

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Is Presurgical Nasoalveolar Molding Therapy More Effective in Unilateral or Bilateral Cleft Lip–Cleft Palate Patients?

Abstract: There are differences in efficacy between unilateral and bilateral cleft lip–cleft palate patients undergoing nasoalveolar molding. Understanding these differences may help physicians and dentists better shape expectations.

Cited by 31 publications

References 12 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

Parental experience caring for cleft lip and palate infants with nasoalveolar moulding

A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

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