Three‐dimensional facial morphology following surgical repair of unilateral cleft lip and palate in patients after nasoalveolar molding

Abstract

Following surgical repair of UCLP in patients previously treated with NAM, 3D facial morphology was virtually indistinguishable from the non-cleft mean. Clinically, the apparent improvement in the facial soft tissues may mask dysmorphic skeletal growth, and further studies are required to characterize the underlying bony changes associated with the soft tissue changes reported here.

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

“…Some of the major advantages of TPSIO are claimed to be the improvement of arch form, the facilitation of surgical closure, and thus improvement of aesthetic outcome, the facilitation of feeding, and improvement of speech (Ross and MacNamera, 1994;Kuijpers-Jagtman et al, 2000;Mishima et al, 2000;Prahl et al, 2001;Konst et al, 2004;Berkowitz, 2006). Advocates of PNAM state that, beside the other advantages of traditional plates, the main objectives of PNAM appliances are improving nasal symmetry and lip aesthetics while elongating the columella and correcting the nasal cartilage Grayson et al, 2001;Liou et al, 2004;Ezzat et al, 2007;Singh et al, 2007;Lee et al, 2008). On the other hand, opponents state that all types of PSIO approaches are complex and expensive and might have an adverse effect on maxillary growth.…”

Uso da estereofotogrametria nas deformidades craniofaciais: revisão sistemática

“…A great source of errors that can be probed in this data extraction is the time to photograph the patient postoperatively (in 10 of 13 articles with some therapeutic approach involving surgery), because if the photograph was taken very early, the final appearance may still not be reflected. Concerning this aspect, the largest discrepancy was observed in surgeries involving the nose, which showed the following follow-up times: 9 weeks 19 ; 1 month 15 ; and 1, 3 3 , and 6 months 17 . Therefore, as the end result of a rhinoplasty can take 6 months to 2 years to show 34 , the article with the longest follow-up time waited only until the lower limit of the safe range.…”

“…When there was correspondence, we used the nomenclature proposed by Farkas & Munro 26 or Kolar & Salter 27 for identification of the reference points in each article. Some of the items made use of nonanthropometric/constructed reference points without connection to a specific anatomical structure 7,9,12,15,23,24 . Tables 1 and 2 list, respectively, the reference points of the 2 conditions addressed more often -nonsynostotic cranial deformities, and cleft lip and palate.…”

“…Seven articles had no control group 3,[8][9][10][11]17,24 , whereas 12 articles included a control group 7,[12][13][14][15][16][18][19][20][21][22][23] .…”

Response to comments on “Effect of an intra-oral nasal dilation appliance on 3-D nasal airway morphology in adults”

“…In addition, Singh et al [4] demonstrated 3-D nasal changes following nonsurgical nasoalveolar molding (NAM) in children with unilateral cleft lip and palate (UCLP). In a further study [5], which also utilized geometric morphometrics, the 3-D nasal morphology following surgical repair of UCLP in patients previously treated with NAM was virtually indistinguishable from the non-cleft control. Thus, according to the Spatial matrix hypothesis [6,7], we expect concomitant skeletal (nasal) developmental decompensation, which remains as the premise of our ongoing research endeavors.…”