Nasal Aesthetic Evaluation Following Pre-Surgical Naso-Alveolar Molding Application: A Single-Blinded Cohort Retrospective Study in Indonesia
DOI:
https://doi.org/10.14228/jprjournal.v8i1.320Keywords:
Nasoalveolar Molding, Nasal Aesthetic, Labioplasty, Cleft Lip, Cleft PalateAbstract
Introduction: As a major facial aesthetic unit, the nose is one of the significant features in cleft lip and palate repair. The use of a naso-alveolar molding (NAM) device was known to help narrow the cleft gap and improve nasal aesthetics. This study aims to evaluate post-operative nasal morphology in unilateral cleft lip and palate patients who had used presurgical NAM, particularly in an established craniofacial centre in one of developing countries.
Methods: A cohort retrospective study was conducted at Cleft Craniofacial Centre, Cipto Mangunkusumo Hospital Indonesia, comparing the nasal symmetry in unilateral cleft lip patients with and without prior application of NAM (NAM and control group), twelve months following primary cheiloplasty. Differences between the cleft and normal side were assessed using standard basilar view photographs based on five points nasal measurements.
Results: A total of twelve patients were enrolled, six with a history of NAM application and six without (control). Overall nasal measurements confirmed a lower mean of differences in the NAM group compared to the control, showing statistically significant results in nostril height, nasal dome height, and columellar height (p <0.05).
Conclusion: This study provides an insight that cleft lip patients with a history of NAM application had superior nasal symmetry compared to patients without presurgical NAM application 1-year post-cheiloplasty. Presurgical NAM application is recommended for patients with unilateral cleft lip and palate.
References
Shaye D, Liu CC, Tollefson TT. Cleft Lip and Palate: An Evidence-Based Review. Facial Plast Surg Clin North Am. 2015 Aug. 23 (3):357-72.
Watkins, S. E., Meyer, R. E., Strauss, R. P., & Aylsworth, A. S. (2014). Classification, Epidemiology, and Genetics of Orofacial Clefts. Clinics in Plastic Surgery, 41(2), 149–163.doi:10.1016/j.cps.2013.12.003
Calzolari E, Bianchi F, Rubini M, et al. ; EUROCAT Working Group. Epidemiology of cleft palate in Europe: implications for genetic research. Cleft Palate Craniofac J. 2004;41:244–249
Butali A, Mossey PA. Epidemiology of orofacial clefts in Africa: methodological challenges in ascertainment. Pan Afr Med J. 2009;2:5.
Jafari A, Zarea K, Mehregan N. The Prevalence of Cleft Lip and Cleft Palate and Related Risk Factors among Iranian Children from 2000 to 2016: a Literature Review. Int J Pediatr 2017; 5(4): 4687-97.
Widayanti N, Sudjatmiko G, Putri NM. Parental Age as a Risk Factor of Children with Cleft Lip in Jakarta Population: Does Paternal Age Play a Role?. Jurnal Plastik Rekonstruksi. 2017; 1:88–94
Cooper ME, Stone RA, Liu YE. Hu DN, Melnick M, Marazita ML. Descriptive epidemiology of nonsyndromic cleft lip with or without cleft palate in Shanghai, Cina, from 1980 to 1989. Cleft Palate Craniofac J. 2000;37(3):274-80.
Jagomagi T, Soots M, Saag M. Epidemiologic factors causing cleft lip and palate and their regularities of occurrences in Estonia. Baltic Dental and Maxillofacial Journal. 2010;12:105-8.
Lubis B, Tjipta GD, Panjaitan AJ, Raid N, Siregar H. Congenital Malformation Among Newborns at Dr. Pirngadi Hospital Medan During 1981-1984. Paediatrica Indonesiana. 1989;29:1-7.
Masloman N, Mustadjab I, Munir M. Congenital Malformation at Guning Wenang Hospital Manado: A Five-Year Spectrum. Paediatrica Indonesiana. 1991;31:294-302.
Gkantidis N, Papamanou DA, Karamolegkou M, Dorotheou D. Esthetic, Functional, and Everyday Life Assessment of Individuals with Cleft Lip and/or Palate. BioMed research international. 2015 Apr 5;2015
Gani B, Kinshuck AJ, Sharma R. A Review of Hearing Loss in Cleft Palate Patients. Int J Otolaryngol. 2012;2012:548698.
McComb HK, Coghlan BA. Primary Repair of the Unilateral Cleft Lip Nose: Completion of a Longitudinal Study. Cleft Palate Craniofac J. 1996:33(1):23-30.
Grayson BH, Maull D. Nasoalveolar Molding for Infants Born with Clefts of the Lip, Alveolus, and Palate. Semin Plast Surg. 2005;19(4):294-301
Grayson BH, Santiago PE, Brecht LE, Cutting CB. Presurgical Nasoalveolar Molding in Infants with Cleft Lip and Palate. Cleft Palate-Craniofac J. 1999;36(6):486-498
Santiago PE, Grayson BH, Gianoutsos MP, Kwon SM, Brecht LE, Cutting CB. Reduced Need for Alveolar Bone Grafting by Presurgical Orthopedics and Primary Gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998;35:77-80.
Henkel K, Gundlach K. Millard gingivoperiosteoplasty: an alternative to osteoplasty of alveolar clefts. Mund Kiefer Gesichtschir 2002;6:261–265
Liou EJW, Subramanian M, Chen PKT, and Huang CS. The Progressive Changes of Nasal Symmetry and Growth after Nasoalveolar Molding: A Three-Year Follow-Up Study. Plast Reconstr Surg. 2004;114: 858-64.
Rachwalski M, Pullan S, Parmar R, Shetty PN, Sharma P, Bonanthaya K. Nasal aesthetics in unilateral cleft lip and palate with and without presurgical nasoalveolar molding: a preliminary assessment. International Journal of Oral and Maxillofacial Surgery. 2017 Mar 1;46:68.
Gomez DF, Donohue ST, Figueroa AA, Polley JW. Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose. The Cleft Palate-Craniofacial Journal. 2012 Nov;49(6):689-700
Keçik D, Enacar A. Effects of nasoalveolar molding therapy on nasal and alveolar morphology in unilateral cleft lip and palate. Journal of Craniofacial Surgery. 2009 Nov 1;20(6):2075-80
Jaeger M, Braga-Silva J, Gehlen D, Sato Y, Zuker R, Fisher D. Correction of the alveolar gap and nostril deformity by presurgical passive orthodontia in the unilateral cleft lip. Annals of plastic surgery. 2007 Nov 1;59(5):489-94
Patel D, Goyal R, Puri T. Presurgical nasoalveolar moulding – An adjunct to facilitate surgical repair in infants with cleft lip and palate. Mod Plast Surg. 2013;3:34–42.
Barillas I, Dec W, Warren SM, Grayson BH. Nasoalveolar molding improves long-term nasal symmetry in complete unilateral cleft lip–cleft palate patients. Plastic and reconstructive surgery. 2009 Mar 1;123(3):1002-6.
Bennun RD, Perandones C, Sepliarsky VA, Chantiri SN, Aguirre MI, Dogliotti PL. Nonsurgical correction of nasal deformity in unilateral complete cleft lip: a 6-year follow-up. Plastic and reconstructive surgery. 1999 Sep;104(3):616-30
Shetty V, Vyas HJ, Sharma SM, Sailer HF. A Comparison of results using nasoalveolar molding in cleft infants treated within 1month of life versus those treated after this period: development of new protocol. Int J Oral Maxillofac Surg.; 2012;41(1):28–36
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Copyright (c) 2021 Dr. dr. Kristaninta Bangun, SpBP-RE(KKF), Prof. dr. Chaula Luthfia Sukasah, SpB, SpBP-RE(K), dr. Jenisa Amanda Sandiarini Kamayana, MRes, dr. Adi Basuki, dr. Jessica Halim, MRes, dr. Nur Eulis Pujiastuti Nahdiyat, MRes, dr. Agatha Novell Harsanto, dr. Arvin Pramudita
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