Lips and noses in 10-year old patients with repaired complete unilateral clefts of lip, alveolus, and palate. A prospective three-centre study of the Baltic Cleft Network

Lenz, Jan-Hendrik; Akota, Ilze; Zaleckas, Linas; Soots, Marianne; Bagante, Ieva; Rogovska, Irena; Frerich, Bernhard; Gundlach, Karsten K.H.

doi:10.1016/j.jcms.2021.12.009

Cited by 3 publications

(3 citation statements)

References 41 publications

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“…Nose evaluations were comparable from NAM (center 1) and nasal stents (center 2). 27 However, lip scars from operations without NAM or nasal stents (center 3) were rated better compared to operations with NAM and nasal stents. 27 All centers experienced no statistical difference regarding lip skin and vermillion.…”

Section: Nasal Stentsmentioning

confidence: 96%

“…Two studies examined nasal stents, with one study retrospectively comparing the application of postoperative nasal stents alone and the other examining the use of nasal stents in combination with other inventions compared to other presurgical and postoperative methods in a multicenter trial. 26,27 With at least 6 months of nasal stent use, 5-to-8 years postoperative photographs showed that nostril symmetry, alar cartilage slump, alar base level, columella tilt, and overall esthetic appearance were significantly improved compared to the group that did not use it. 26 In the multicenter clinical trial, 3 centers had different interventions: center 1 consisted of 42 patients that had presurgical nasoalveolar molding (NAM) and presurgical Hotz plates, center 2 consisted of 19 patients who had a presurgical Hotz plate and postoperative nasal stents, and center 3 consisted of 15 patients without presurgical orthodontics or postoperative nasal stents.…”

Section: Nasal Stentsmentioning

confidence: 99%

“…26 In the multicenter clinical trial, 3 centers had different interventions: center 1 consisted of 42 patients that had presurgical nasoalveolar molding (NAM) and presurgical Hotz plates, center 2 consisted of 19 patients who had a presurgical Hotz plate and postoperative nasal stents, and center 3 consisted of 15 patients without presurgical orthodontics or postoperative nasal stents. 27 Postoperative photographs were evaluated using a visual rating scale of the nose, lip skin, lip scar, and vermillion. Nose evaluations were comparable from NAM (center 1) and nasal stents (center 2).…”

Section: Nasal Stentsmentioning

confidence: 99%

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A Scoping Review of Adjuvant Perioperative Therapies for Primary Cleft Lip Repair

Lem,

T Pham,

Arora

et al. 2023

FACE

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Background:To date, there is little guidance regarding current adjuvant therapies for primary surgical repair of cleft lip. There are studies on the effect of botulinum toxin type A, revision fat grafting, silicone gel and sheeting, intense pulsed light, and carbon dioxide lasers to ameliorate contracture and hypertrophic scar formation, but a comprehensive review of these options is lacking. The aim of this scoping review is to examine adjuvant techniques and therapies that modulate scar outcomes for primary cleft lip repair outcomes in the perioperative period. Methods: PROSPERO, PubMed/MEDLINE, SCOPUS, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrial.gov were searched for studies that evaluated adjuvant therapies for primary cleft lip repair. Results: The initial search resulted in 688 studies, with 48 studies including relevant key terms in the title and abstract screening. After the full-text screening, 11 studies were included in the final scoping review. These included 3 studies about use of botulinum toxin injection, 2 studies about fat grafting, 2 studies about nasal stents, and 4 studies about various topical treatments. In the Jadad quality index evaluation and MINORS assessment of the methodological quality of the included papers, there was a strong level of agreement among the 2 raters respectively (weighted κ = 1, κ = 0.817, both P-value < .0001). Conclusion: From this scoping review, adjuvant therapies such as utilizing botulinum toxin and immediate fat grafting intraoperatively and nasal stents and topical treatments including antibiotic ointment, lidocaine, hydrogen peroxide, and silicone gels postoperatively are worthwhile to consider as a combination of adjuvant treatments to prevent adverse scar formation in patients undergoing primary cleft lip repair. The most robust evidence lies with botulinum toxin use.

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Section: Nasal Stentsmentioning

confidence: 96%