Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate

Catherine T.H. Lee, Judah Garfinkle, Stephen M. Warren, Lawrence E. Brecht, Court B. Cutting, Barry H. Grayson

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

BACKGROUND: Bilateral cleft lip-cleft palate is associated with nasal deformities typified by a short columella. The authors compared nasal outcomes of cleft patients treated with banked fork flaps to those of patients who underwent nasoalveolar molding and primary retrograde nasal reconstruction. METHODS: A retrospective review of 26 consecutive patients with bilateral cleft lip-cleft palate was performed. Group 1 patients (n = 13) had a cleft lip repair and nasal correction with banked fork flaps. Group 2 patients (n = 13) had nonsurgical columellar elongation with nasoalveolar molding followed by cleft lip closure and primary retrograde nasal correction. Group 3 patients (n = 13) were age-matched controls. Columellar length was measured at presentation and at 3 years of age. The number of nasal operations was recorded to 9 years. The Kruskal-Wallis and Tukey-Kramer tests were used for statistical analysis. RESULTS: Initial columellar length was 0.49 ± 0.37 mm in group 1 and 0.42 ± 0.62 mm in group 2. Post-nasoalveolar molding columellar length was 4.5 ± 0.76 mm in group 2. By 3 years of age, columellar length was 3.03 ± 1.47 mm in group 1, 5.98 ± 1.09 mm in group 2, and 6.35 ± 0.99 mm in group 3. Group 2 columellar length was significantly greater (p < 0.001) than that of group 1 and not statistically different from that of group 3 (p > 0.05). All group 1 patients (13 of 13) needed secondary nasal surgery. No nasoalveolar molding patients (zero of 13, group 2) required secondary nasal surgery. CONCLUSION: Nonsurgical columellar elongation with nasoalveolar molding followed by primary retrograde nasal reconstruction restored columellar length to normal by 3 years and significantly reduced the need for secondary nasal surgery.

Original languageEnglish (US)
Pages (from-to)1131-1137
Number of pages7
JournalPlastic and reconstructive surgery
Volume122
Issue number4
DOIs
StatePublished - Oct 1 2008
Externally publishedYes

Fingerprint

Cleft Lip
Cleft Palate
Nose
Nasal Surgical Procedures

ASJC Scopus subject areas

  • Surgery

Cite this

Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate. / Lee, Catherine T.H.; Garfinkle, Judah; Warren, Stephen M.; Brecht, Lawrence E.; Cutting, Court B.; Grayson, Barry H.

In: Plastic and reconstructive surgery, Vol. 122, No. 4, 01.10.2008, p. 1131-1137.

Research output: Contribution to journalArticle

Lee, Catherine T.H. ; Garfinkle, Judah ; Warren, Stephen M. ; Brecht, Lawrence E. ; Cutting, Court B. ; Grayson, Barry H. / Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate. In: Plastic and reconstructive surgery. 2008 ; Vol. 122, No. 4. pp. 1131-1137.
@article{9c5ce9c34c414b6b883c8b6099987b45,
title = "Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate",
abstract = "BACKGROUND: Bilateral cleft lip-cleft palate is associated with nasal deformities typified by a short columella. The authors compared nasal outcomes of cleft patients treated with banked fork flaps to those of patients who underwent nasoalveolar molding and primary retrograde nasal reconstruction. METHODS: A retrospective review of 26 consecutive patients with bilateral cleft lip-cleft palate was performed. Group 1 patients (n = 13) had a cleft lip repair and nasal correction with banked fork flaps. Group 2 patients (n = 13) had nonsurgical columellar elongation with nasoalveolar molding followed by cleft lip closure and primary retrograde nasal correction. Group 3 patients (n = 13) were age-matched controls. Columellar length was measured at presentation and at 3 years of age. The number of nasal operations was recorded to 9 years. The Kruskal-Wallis and Tukey-Kramer tests were used for statistical analysis. RESULTS: Initial columellar length was 0.49 ± 0.37 mm in group 1 and 0.42 ± 0.62 mm in group 2. Post-nasoalveolar molding columellar length was 4.5 ± 0.76 mm in group 2. By 3 years of age, columellar length was 3.03 ± 1.47 mm in group 1, 5.98 ± 1.09 mm in group 2, and 6.35 ± 0.99 mm in group 3. Group 2 columellar length was significantly greater (p < 0.001) than that of group 1 and not statistically different from that of group 3 (p > 0.05). All group 1 patients (13 of 13) needed secondary nasal surgery. No nasoalveolar molding patients (zero of 13, group 2) required secondary nasal surgery. CONCLUSION: Nonsurgical columellar elongation with nasoalveolar molding followed by primary retrograde nasal reconstruction restored columellar length to normal by 3 years and significantly reduced the need for secondary nasal surgery.",
author = "Lee, {Catherine T.H.} and Judah Garfinkle and Warren, {Stephen M.} and Brecht, {Lawrence E.} and Cutting, {Court B.} and Grayson, {Barry H.}",
year = "2008",
month = "10",
day = "1",
doi = "10.1097/PRS.0b013e318184590c",
language = "English (US)",
volume = "122",
pages = "1131--1137",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate

AU - Lee, Catherine T.H.

AU - Garfinkle, Judah

AU - Warren, Stephen M.

AU - Brecht, Lawrence E.

AU - Cutting, Court B.

AU - Grayson, Barry H.

PY - 2008/10/1

Y1 - 2008/10/1

N2 - BACKGROUND: Bilateral cleft lip-cleft palate is associated with nasal deformities typified by a short columella. The authors compared nasal outcomes of cleft patients treated with banked fork flaps to those of patients who underwent nasoalveolar molding and primary retrograde nasal reconstruction. METHODS: A retrospective review of 26 consecutive patients with bilateral cleft lip-cleft palate was performed. Group 1 patients (n = 13) had a cleft lip repair and nasal correction with banked fork flaps. Group 2 patients (n = 13) had nonsurgical columellar elongation with nasoalveolar molding followed by cleft lip closure and primary retrograde nasal correction. Group 3 patients (n = 13) were age-matched controls. Columellar length was measured at presentation and at 3 years of age. The number of nasal operations was recorded to 9 years. The Kruskal-Wallis and Tukey-Kramer tests were used for statistical analysis. RESULTS: Initial columellar length was 0.49 ± 0.37 mm in group 1 and 0.42 ± 0.62 mm in group 2. Post-nasoalveolar molding columellar length was 4.5 ± 0.76 mm in group 2. By 3 years of age, columellar length was 3.03 ± 1.47 mm in group 1, 5.98 ± 1.09 mm in group 2, and 6.35 ± 0.99 mm in group 3. Group 2 columellar length was significantly greater (p < 0.001) than that of group 1 and not statistically different from that of group 3 (p > 0.05). All group 1 patients (13 of 13) needed secondary nasal surgery. No nasoalveolar molding patients (zero of 13, group 2) required secondary nasal surgery. CONCLUSION: Nonsurgical columellar elongation with nasoalveolar molding followed by primary retrograde nasal reconstruction restored columellar length to normal by 3 years and significantly reduced the need for secondary nasal surgery.

AB - BACKGROUND: Bilateral cleft lip-cleft palate is associated with nasal deformities typified by a short columella. The authors compared nasal outcomes of cleft patients treated with banked fork flaps to those of patients who underwent nasoalveolar molding and primary retrograde nasal reconstruction. METHODS: A retrospective review of 26 consecutive patients with bilateral cleft lip-cleft palate was performed. Group 1 patients (n = 13) had a cleft lip repair and nasal correction with banked fork flaps. Group 2 patients (n = 13) had nonsurgical columellar elongation with nasoalveolar molding followed by cleft lip closure and primary retrograde nasal correction. Group 3 patients (n = 13) were age-matched controls. Columellar length was measured at presentation and at 3 years of age. The number of nasal operations was recorded to 9 years. The Kruskal-Wallis and Tukey-Kramer tests were used for statistical analysis. RESULTS: Initial columellar length was 0.49 ± 0.37 mm in group 1 and 0.42 ± 0.62 mm in group 2. Post-nasoalveolar molding columellar length was 4.5 ± 0.76 mm in group 2. By 3 years of age, columellar length was 3.03 ± 1.47 mm in group 1, 5.98 ± 1.09 mm in group 2, and 6.35 ± 0.99 mm in group 3. Group 2 columellar length was significantly greater (p < 0.001) than that of group 1 and not statistically different from that of group 3 (p > 0.05). All group 1 patients (13 of 13) needed secondary nasal surgery. No nasoalveolar molding patients (zero of 13, group 2) required secondary nasal surgery. CONCLUSION: Nonsurgical columellar elongation with nasoalveolar molding followed by primary retrograde nasal reconstruction restored columellar length to normal by 3 years and significantly reduced the need for secondary nasal surgery.

UR - http://www.scopus.com/inward/record.url?scp=53149138579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53149138579&partnerID=8YFLogxK

U2 - 10.1097/PRS.0b013e318184590c

DO - 10.1097/PRS.0b013e318184590c

M3 - Article

VL - 122

SP - 1131

EP - 1137

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 4

ER -