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Midface Growth in Patients With Unilateral Cleft Lip and Palate Treated With a Nasoalveolar Molding Protocol

Rubin, Marcie S., DrPH, MPH*; Clouston, Sean A.P., PhD; Esenlik, Elçin, DDS, PhD; Shetye, Pradip R., DDS, MDS§; Flores, Roberto L., MD; Grayson, Barry H., DDS, MS||

doi: 10.1097/SCS.0000000000005356
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This retrospective cohort study aimed to determine the impact of a nasoalveolar molding (NAM) protocol on midface growth in school-aged children with non-syndromic unilateral cleft lip and palate (UCLP). Data from 56 consecutively treated, NAM-prepared, Caucasian patients with non-syndromic UCLP from a single US cleft palate center were compared to pooled center data based on 56 patients with non-syndromic UCLP treated at 2 Eurocleft centers that did not use presurgical infant orthopedics (non-PSIO). Lateral cephalograms were obtained and 28 landmarks were identified. Published cephalometric measurements from Eurocleft centers were used for comparison. Seven cephalometric measurements (SNA, SNB, ANB, A’N’B’, G’-Sn’-Pg’, Sn-CT-LS, ANS-Me/N-Me%), available or derivable for both centers, were analyzed. Means and standard deviations for the 7 measurements were calculated for the NAM center. Student's t-tests were used to compare group means for 6 of the measures and a test of proportion was used for ANS-Me/N-Me%. No significant differences were found between the NAM protocol-prepared group and the Eurocleft non-PSIO centers on any of the 7 analyzed cephalometric relationships after accounting for false discovery rate. The NAM treatment protocol does not appear to impact skeletal or soft tissue facial growth in school-aged children with non-syndromic UCLP.

*Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine

Department of Family, Population, and Preventative Maintenance, Renaissance School of Medicine, Stony Brook University, NY

Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, NY; Süeyman Demirel University Faculty of Dentistry, Department of Orthodontics, Isparta, Turkey

§Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine

Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine

||Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, NY.

Address correspondence and reprint requests to Marcie S. Rubin, DrPH, MPH, Dr., Hansjörg Wyss Department of Plastic Surgery, 307 East 33rd Street, Lower Level, New York, NY 10016; E-mail: marcie.rubin@nyumc.org

Received 13 June, 2018

Accepted 20 December, 2018

The manuscript was presented orally at the Annual Meeting of the American Cleft-Palate Craniofacial Association on April 8, 2016 in Atlanta, Georgia.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

© 2019 by Mutaz B. Habal, MD.