대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제25권3호
  • /
  • Pages.123-132
  • /
  • 2024
  • /
  • 2287-1152(pISSN)
  • /
  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
권호 표지
DOI QR코드

DOI QR Code

The nasoalveolar molding technique versus DynaCleft nasal elevator application in infants with unilateral cleft lip and palate

  • Abdallah Bahaa (Department of Orthodontics, Faculty of Dental Medicine for Boys, Al-Azhar University) ;
  • Nada El-Bagoury (Innovinity Medical Hub) ;
  • Noura Khaled (Innovinity Medical Hub) ;
  • Sameera Mohamed (Innovinity Medical Hub) ;
  • Ahmed Bahaa (Innovinity Medical Hub) ;
  • Ahmed Mohamed Ibrahim (Innovinity Medical Hub) ;
  • Khaled Mohamad Taha (Department of Orthodontics, Faculty of Dental Medicine for Boys, Al-Azhar University) ;
  • Mohsena Ahmad Abdarrazik (Department of Orthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University)
  • 투고 : 2024.03.07
  • 심사 : 2024.06.11
  • 발행 : 2024.06.20
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion: Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

키워드

과제정보

The authors received support from the SmileTrain Organization for the research, authorship, and publication of this article.

참고문헌

  1. Kosowski TR, Weathers WM, Wolfswinkel EM, Ridgway EB. Cleft palate. Semin Plast Surg 2012;26:164-9. 
  2. Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet 2009;374:1773-85. 
  3. Smith KS, Henry BT, Scott MA. Presurgical dentofacial orthopedic management of the cleft patient. Oral Maxillofac Surg Clin North Am 2016;28:169-76. 
  4. Grayson BH, Santiago PE, Brecht LE, Cutting CB. Presurgical nasoalveolar molding in infants with cleft lip and palate. Cleft Palate Craniofac J 1999;36:486-98. 
  5. Grayson BH, Maull D. Nasoalveolar molding for infants born with clefts of the lip, alveolus, and palate. Clin Plast Surg 2004;31:149-58. 
  6. Grayson BH, Cutting CB. Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants born with unilateral and bilateral clefts. Cleft Palate Craniofac J 2001;38:193-8. 
  7. Matsuo K, Hirose T, Otagiri T, Norose N. Repair of cleft lip with nonsurgical correction of nasal deformity in the early neonatal period. Plast Reconstr Surg 1989;83:25-31. 
  8. Habel A, Sell D, Mars M. Management of cleft lip and palate. Arch Dis Child 1996;74:360-6. 
  9. Monasterio L, Ford A, Gutierrez C, Tastets ME, Garcia J. Comparative study of nasoalveolar molding methods: nasal elevator plus DynaCleft(R) versus NAM-Grayson in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 2013;50:548-54. 
  10. Abhinav BA, Batra P, Chander Sood S, Sharma K, Srivastava A, Raghavan S. Comparative study of presurgical infant orthopedics by modified Grayson method and Dynacleft with nasal elevators in patients with unilateral cleft lip and palate: a clinical prospective study. Cleft Palate Craniofac J 2021;58:189-201. 
  11. Carlson LN, Vinson LA, Sanders BJ, Jones JE. The effect of DynaCleft(R) on presurgical orthopedics in bilateral cleft lip and palate patients. J Cleft Lip Palate Craniofacial Anomalies 2019;6:110-3. 
  12. Wadde K, Chowdhar A, Venkatakrishnan L, Ghodake M, Sachdev SS, Chhapane A. Protocols in the management of cleft lip and palate: a systematic review. J Stomatol Oral Maxillofac Surg 2023;124:101338. 
  13. Dunworth K, Porras Fimbres D, Trotta R, Hollins A, Shammas R, Allori AC, et al. Systematic review and critical appraisal of the evidence base for nasoalveolar molding (NAM). Cleft Palate Craniofac J 2024;61:654-77. 
  14. Castillo T, Luisa PP, Clark P, Robertson JP, Montalva FM, Figueroa AA, et al. Developing a core outcome set for anthropometric evaluation for presurgical infant orthopaedics for unilateral cleft lip and palate: e-Delphi consensus. J Plast Reconstr Aesthet Surg 2022;75:3795-803. 
  15. Precious DS. Primary unilateral cleft lip/nose repair using the "Delaire" technique. Atlas Oral Maxillofac Surg Clin North Am 2009;17:125-35. 
  16. Pai BC, Ko EW, Huang CS, Liou EJ. Symmetry of the nose after presurgical nasoalveolar molding in infants with unilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J 2005;42:658-63. 
  17. Abd El-Ghafour M, Aboulhassan MA, El-Beialy AR, Fayed MM, Eid FH, Emara D, et al. Does presurgical taping change nose and lip aesthetics in infants with unilateral cleft lip and palate? A randomized controlled trial. Plast Reconstr Surg 2022;150:1300e-1313e. 
  18. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-91. 
  19. Haar M. RANDOM.ORG: True Random Number Service [Internet]. RANDOM.ORG; c2018 [cited 2024 Jun 15]. Available from: https://www.random.org 
  20. R Core Team. The R Language and Environment for Statistical Computing [Internet]. R Foundation for Statistical Computing; c2023 [cited 2024 Jun 15]. Available from: https://www.R-project.org/ 
  21. Posit team. RStudio: Integrated Development Environment for R [Internet]. Posit Software, PBC; c2023 [cited 2024 Jun 15]. Available from: http://www.posit.co/ 
  22. Wickham H, Averick M, Bryan J, Chang W, McGowan LD, Francois R, et al. Welcome to the tidyverse. J Open Source Softw 2019;4:1686. 
  23. Kassambara A. rstatix: pipe-friendly framework for basic statistical tests [Internet]. R Foundation; c2023 [cited 2024 Jun 15]. Available from: https://CRAN.R-project.org/package=rstatix 
  24. Xie Y. knitr: Elegant, flexible, and fast dynamic report generation with R [Internet]. Yihui Xie; c2023 [cited 2024 Jun 15]. Available from: https://yihui.org/knitr/ 
  25. Zhu H. kableExtra: construct complex table with "kable" and pipe syntax [Internet]. R Foundation; c2021 [cited 2024 Jun 15]. Available from: https://CRAN.R-project.org/package=kableExtra. 
  26. Revelle WR. psych: procedures for psychological, psychometric, and personality research [Internet]. Northwestern University; c2023 [cited 2024 Jun 15]. Available from: https://www.scholars.northwestern.edu/en/publications/psych-procedures-for-personality-and-psychological-research 
  27. Vinson L. The effect of DynaCleft(R) on cleft width in unilateral cleft lip and palate patients. J Clin Pediatr Dent 2017;41:442-5. 
  28. Jahanbin A, Jamalinasab A, Ramazanzadeh BA, Zarch SH, Shafaee H, Shojaeian R. The effect of immediate versus delayed addition of the nasal stent to the nasoalveolar molding plate on nostrils shape and cleft width in infants with unilateral cleft lip and palate. J Craniofac Surg 2020;31:1633-6. 
  29. Schaaf H, Wilbrand JF, Boedeker RH, Howaldt HP. Accuracy of photographic assessment compared with standard anthropometric measurements in nonsynostotic cranial deformities. Cleft Palate Craniofac J 2010;47:447-53.