Effect of Nasoalveolar Molding on Nasal Symmetry in Patients With Cleft Lip and Palate: A Systematic Review

Abstract

Context: One of the main types of nasal deformity is unilateral cleft lip/palate, which affects the process of breathing and smelling. It is supposed that nasoalveolar molding (NAM) has a positive effect on the reduction of the tension in lips and helps to simplify or even eliminate the subsequent orthodontic treatment. Objective: This systematic review of papers focused on the effectiveness of NAM in patients with unilateral cleft lip/palate. Data Sources: The web search of Google Scholar, PubMed, Web of Science, and Medline databases Study Selection: The identification of 1282 articles published up to 2018. The selected papers were screened based on the eligibility criteria after the thorough investigation of the titles and abstract. In the next step, article inconsistent with our objectives were removed from the current study. Afterward, the papers were thoroughly studied and data related to our study goals were extracted and recorded in predetermined extraction forms. After the full-text evaluation of the articles, results in the selection of 22 articles. Data Extraction: The search process was performed by the following keywords in combination with nasoalveolar molding or pre-surgical nasoalveolar molding or pre-surgical orthopaedic appliances: unilateral cleft lip/palate, UCL/P, Cleft lip, Cleft palate. Results: Based on the literature review, various studies have supported the effectiveness of nasoalveolar molding appliance therapy on nasal symmetry in unilateral clefts of the lip and/or palate treatment. Conclusions: The NAM therapy is effective in decreasing the severity of the initial cleft deformity, as well as repositioning of deformed nasal cartilage and alveolar process. It has many beneficial results in surgical outcomes. However, the long-term effect of this approach has remained unclear.

Psychosocial Maternal Perception of the Outcome of Pre Surgical Infant Orthopedics in Infants Born with Cleft Lip and Palate

“…The various problems associated with such a defect like compromised physical appearance, speech difficulties, feeding problems, repeated infections, commitment to attend clinical appointments causing absence from school/work and financial burden leads to stigmatization of the problem 15 . A number of studies have quantified the morphological changes brought about by the pre surgical orthopedic procedures carried out prior to the primary lip repair 19,20,21 , but only a few have assessed the parent's perception about the outcome of this procedure. In this study, we found that the mothers could very well appreciate the morphological changes in all the 5 parameters evaluated for facial appearances.…”

Evaluation of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate Using Cone Beam Computed Tomography

“…Furthermore, the tip of the nose points toward the cleft side, whereas the septal base points toward the noncleft side. This process may lead to NSD, especially in the anterior part (Namdar et al, 2020). The septal deviation may cause a narrowed or blocked meatus pushing the middle concha toward the lateral wall.…”

Ortopedia prequirúrgica en el tratamiento de pacientes con fisura labio y paladar.

“…Cuál es la evidencia Véase matriz de evidencia en Epistemonikos más abajo. Encontramos 14 revisiones sistemáticas (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) que incluyen 39 estudios primario en 57 referencias, de las cuales cinco corresponden a ensayos aleatorizados (31,42,49,57,74) , reportados en 21 referencias (26,27,29,31,(38)(39)(40)42,45,48,49,54,57,(71)(72)(73)(74)(75)(76)(77)(78) (17 referencias pertenecen al hilo de publicación "DUTCHCLEFT") Esta tabla y el resumen en general se basan en estos últimos, dado que los estudios observacionales no aumentaban la certeza de la evidencia existente, ni entregaban información adicional relevante. en parámetros sagitales, verticales y transversales a los cuatro a seis años (baja certeza de evidencia).…”