The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study

Abstract

Background:Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry.Methods:We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls. The children were evaluated in their fifth year of life. Three midline and 3 bilateral orthopometric midface landmarks were programmed using a custom software (OnyxCeph3, Image Instruments GmbH, Germany), and corresponding linear measurements from the midline were obtained and compared between the groups using 1-way analysis of variance and Scheffe’s post hoc test.Results:Significant differences were observed between the control and CUCLP groups for the measurements of the proanasale, subnasale, and zygion. However, there were no significant differences between the PNAM and no nasoalveolar molding groups for the 6 midface landmarks.Conclusions:PNAM does not seem to significantly impact the long-term midface symmetry in children with CUCLP.

Long-Term Effects of Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate: A Systematic Review and Meta-Analysis

“…A total of 439 publications were identified, and 13 publications met criteria for inclusion in this review (Figure 1) (Barillas, 2009; Chang et al, 2010; Clark, 2011; Shetty, 2017; Akarsu-Guven, 2018; AlHayyan et al, 2018; Kornbluth, 2018; Massie, 2018; Peanchitlertkajorn, 2018a; Peanchitlertkajorn, 2018b; Singer, 2018; Funayama et al, 2019). The fully reproducible search strategy is included in the Online Appendix.…”

Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding

“…Substantial skeletal changes take place during infancy, and the landmark points on bone may change significantly between the affected and control sides as the child grows. AlHayyan et al (2018) reported a long-term study of skeletal changes achieved using the NAM method over a period of 5 years. According to their study, the In a previous study, we compared the shape of the nostrils at 1 month after the primary cheiloplasty between a group of patients who received treatment using the NAM method and another of patients treated using a conventional appliance (Sasaki et al, 2012).…”

Comparative Photographic, Retrospective Analysis of Nonsyndromic Cleft Noses Treated with or without NAM

“…AlHayyan et al described no significant impact on long-term midface symmetry of presurgical NAM in children with UCLP when compared with children treated without any form of presurgical infant orthopedics. 17 Furthermore, some studies describe a relapse of initially good results. We are not able to prove or disprove these observations with our presented study but clinically agree that in some cases a relapse might be observed.…”

“… 14 – 16 More recently, favorable long-term results have been described, revealing a previously described assumption that NAM therapy might reduce the need for secondary corrections. 7 , 11 , 17 , 18 …”