Document Detail

Limited evidence for the effect of presurgical nasoalveolar molding in unilateral cleft on nasal symmetry: a call for unified research.
MedLine Citation:
PMID:  23271555     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In the past two decades, presurgical nasoalveolar molding has been applied increasingly in the care of patients with a cleft to improve nasal symmetry and facilitate closure of the lip and secondary rhinoplasty. Many cleft centers do not apply presurgical molding, because its effect is disputed. This review aims to quantify the effect of nasal symmetry in the long term.
METHODS: A systematic review of the literature with the intention of performing a meta-analysis was performed. The search terms "cleft" AND ("molding" OR "moulding") were used in three databases. Twelve studies met the following inclusion criteria: (1) participants were humans with nonsyndromic unilateral cleft; (2) data concerning the effect of nasoalveolar molding on symmetry of the nose are reported or can be deduced; (3) article was written in English, German, or Dutch.
RESULTS: The heterogeneity of the study designs, outcome variables, outcome variable expressions, follow-up periods, and inadequate data reporting made it impossible to calculate effect sizes and to perform a meta-analysis. All studies had a low Grading of Recommendations Assessment, Development and Evaluation level. Five studies reported exclusively positive effects on nasal symmetry, six studies reported mixed effects, and one study reported exclusively no effects.
CONCLUSIONS: Results of studies of nasoalveolar molding are inconsistent regarding changes in nasal symmetry; however, there is a trend toward a positive effect. Studies concerning nasoalveolar molding in unilateral cleft lip, jaw, and palate are heterogeneous and lack adequate reporting. Recommendations for future research were provided to construct a consensus about the effect of nasoalveolar molding.
Perry van der Heijden; Pieter U Dijkstra; Cees Stellingsma; Bernard F van der Laan; Astrid G W Korsten-Meijer; Sieneke M Goorhuis-Brouwer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-28     Completed Date:  2013-02-25     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  62e-71e     Citation Subset:  AIM; IM    
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MeSH Terms
Alveolar Process / abnormalities
Cleft Lip / surgery,  therapy*
Cleft Palate / surgery,  therapy*
Combined Modality Therapy
Facial Asymmetry / congenital,  therapy*
Nose / abnormalities*,  surgery
Orthopedic Procedures / methods*
Reconstructive Surgical Procedures
Treatment Outcome
Comment In:
Plast Reconstr Surg. 2013 Jan;131(1):75e-6e   [PMID:  23271557 ]
Plast Reconstr Surg. 2013 Jan;131(1):72e-4e   [PMID:  23271556 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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