The Nasoalveolar Molding Cleft Protocol: Long-Term Treatment Outcomes from Birth to Facial Maturity
| Autor: | David A. Staffenberg, Buddhathida Wangsrimongkol, Barry H Grayson, Court B. Cutting, Lauren M. Yarholar, Roberto L. Flores, Pradip R. Shetye, Chen Shen |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Cephalometric analysis Long term treatment Adolescent Nasoalveolar Molding Cleft Lip medicine.medical_treatment Orthognathic surgery Dentistry 030230 surgery Young Adult 03 medical and health sciences 0302 clinical medicine Velopharyngeal insufficiency medicine Humans Child Nose Retrospective Studies business.industry Incidence (epidemiology) Infant Newborn Infant Cleft Palate Treatment Outcome medicine.anatomical_structure Bilateral cleft lip Child Preschool Face 030220 oncology & carcinogenesis Female Surgery Alveolar bone grafting business Follow-Up Studies |
| Zdroj: | Plastic & Reconstructive Surgery. 147:787e-794e |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000007828 |
| Popis: | Background The authors present outcomes analysis of the nasoalveolar molding treatment protocol in patients with a cleft followed from birth to facial maturity. Methods A single-institution retrospective review was conducted of cleft patients who underwent nasoalveolar molding between 1990 and 2000. Collected data included surgical and orthodontic outcomes and incidence of gingivoperiosteoplasty, alveolar bone grafting, surgery for velopharyngeal insufficiency, palatal fistula repair, orthognathic surgery, nose and/or lip revision, and facial growth. Results One hundred seven patients met inclusion criteria (69 with unilateral and 38 with bilateral cleft lip and palate). Eighty-five percent (91 of 107) underwent gingivoperiosteoplasty (unilateral: 78 percent, 54 of 69; bilateral: 97 percent, 37 of 38). Of those patients, 57 percent (52 of 91) did not require alveolar bone grafting (unilateral: 59 percent, 32 of 54; bilateral: 54 percent, 20 of 37). Twelve percent (13 of 107) of all study patients underwent revision surgery to the lip and/or nose before facial maturity (unilateral: 9 percent, six of 69; bilateral: 18 percent, seven of 38). Nineteen percent (20 of 107) did not require a revision surgery, alveolar bone grafting, or orthognathic surgery (unilateral: 20 percent, 14 of 69; bilateral: 16 percent, six of 38). Cephalometric analysis was performed on all patients with unilateral cleft lip and palate. No significant statistical difference was found in maxillary position or facial proportion. Average age at last follow-up was 20 years (range, 15 years 4 months to 26 years 10 months). Conclusions Nasoalveolar molding demonstrates a low rate of soft-tissue revision and alveolar bone grafting, and a low number of total operations per patient from birth to facial maturity. Facial growth analysis at facial maturity in patients who underwent gingivoperiosteoplasty and nasoalveolar molding suggests that this proposal may not hinder midface growth. Clinical question/level of evidence Therapeutic, IV. |
| Databáze: | OpenAIRE |
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