Simple modified preoperative nasoalveolar moulding in infants with unilateral cleft lip and palate

Iino, Mitsuyoshi; Wako, Masahiko; Masayuki, Fukuda

doi:10.1016/j.bjoms.2004.06.002

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…Among others, these techniques include oral pinning and traction, pinned co-axial screw, advancement of the cleft maxillary segment, nasal stenting, nasoalveolar molding (NAM) and modifications of NAM [1–4]. NAM was introduced into cleft care and first described by Grayson in the early 1990s [4].…”

Section: Introductionmentioning

confidence: 99%

“…It is based on the high degree of plasticity in the cartilage of neonates due to transient high levels of oestrogen and hyaluronic acid in the early postnatal period [5]. In cleft care, optimal timing of the treatment steps is essential to optimize functional and aesthetic outcome [1,6,7]. Unfortunately, high-level evidence-based studies in the field of NAM are still rare, although a trend towards a significantly positive long-term effect is seen in its application [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Nasoalveolar Molding in Cleft Care—Experience in 40 Patients from a Single Centre in Germany

et al. 2015

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Nasoalveolar molding (NAM) has gained wide acceptance and evidence in cleft therapy. However, standardized treatment protocols and experiences recorded from European centres are lacking. The results of 40 infants with cleft lip and palate treated with presurgical NAM according to the Grayson technique were analyzed. Standardized parameters of cleft width and nasal symmetry were measured in pre- and posttreatment plaster casts and in digitalized 3-dimensional STL models. Statistical analyses were performed by using Student´s t-test in a per-protocol manner. 27 out of 40 infants completed NAM and were analyzed. In 13 patients NAM was either temporarily interrupted or terminated prematurely due to skin irritations or lack of parental support. These cases were excluded from statistical analysis, resulting in a drop-out rate of 32.5%. Intersegmental alveolar distance (ISAD), intersegmental lip distance (ISLD), nostril height (NH), nostril width (NW) and columella deviation angle (CDA) were significantly changed in unilateral cleft lip and palate (UCLP) (n = 8). In unilateral cleft lip (UCL) (n = 9), only ISLD, NH and CDA were significantly changed. ISAD of the right and left side, ISLD of the right and left side, premaxilla deviation angle, nostril height and columella length were changed significantly in bilateral cleft lip and palate (BCLP) cases (n = 10). NAM is a suitable presurgical treatment modality. A positive effect has been seen in UCLP and BCLP infants, as compared with their birth status.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nasoalveolar Molding in Cleft Care—Experience in 40 Patients from a Single Centre in Germany

et al. 2015

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“…Since the description of the NAM appliance by Grayson et al [ 6 ], several modifications have been proposed. Mitsuyoshi et al [ 57 ] reported the first modification in 2004. They suggested the use of a nasal stent constructed in cobalt-chrome wire, which is believed to enhance manual control of the force and direction of the stent by the operator [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…Mitsuyoshi et al [ 57 ] reported the first modification in 2004. They suggested the use of a nasal stent constructed in cobalt-chrome wire, which is believed to enhance manual control of the force and direction of the stent by the operator [ 57 ]. Bennun and Figueroa [ 35 ] provided another modification known as dynamic presurgical nasal remodelling.…”

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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“…Preoperative nasoalveolar molding, previously described by Grayson et al (1993), is a well-known technique for treatment of both unilateral and bilateral cleft lip and palate (Mitsuyoshi et al, 2004; Liou et al, 2007). Preoperative nasoalveolar molding ideally begins before the age of 6 weeks to utilize the pliability of the nasal cartilages.…”

mentioning

confidence: 99%

Management of Prominent Premaxilla in Bilateral Cleft Lip and Alveolus

Nemes

Fábián

Nagy³

2013

The Cleft Palate Craniofacial Journal

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Our aim was to describe the early management protocol of the prominent premaxilla in bilateral cleft lip and alveolus and its rationale, as used in the Cleft Centre at the 1st Department of Pediatrics and at the Department of Pedodontics and Orthodontics at the Semmelweis University Budapest. The non-surgical and surgical procedures included lip taping, nasoalveolar molding, lip adhesion and definitive one-stage lip closure. With this treatment sequence, arch management was satisfactory and at the time of the definitive lip closure the position of the premaxilla did not interfere with adequate surgical repair.

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Simple modified preoperative nasoalveolar moulding in infants with unilateral cleft lip and palate

Cited by 10 publications

References 5 publications

Nasoalveolar Molding in Cleft Care—Experience in 40 Patients from a Single Centre in Germany

Nasoalveolar Molding in Cleft Care—Experience in 40 Patients from a Single Centre in Germany

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

Management of Prominent Premaxilla in Bilateral Cleft Lip and Alveolus

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