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Presurgical Nasoalveolar Molding Orthopedic Treatment Improves the Outcome of Primary Cheiloplasty of Unilateral Complete Cleft Lip and Palate, as Assessed by Naris Morphology and Cleft Gap.
MedLine Citation:
PMID:  23147280     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT: We evaluated the effects of presurgical nasoalveolar molding (NAM) with an orthopedic appliance and compared them with a passive orthopedic method (Hotz plate, HP), focusing on the naris morphology and width of the alveolar and palate cleft gap. The subjects were 28 unilateral complete cleft lip and palate patients treated with primary cheiloplasty at Tsukuba University Hospital from 2004 to 2011. Thirteen patients were treated preoperatively with NAM (NAM group), and 15 with HP (HP group). The surgical outcome was assessed according to left-right naris symmetry, as measured by the area ratio, perimeter ratio, aspect a/u ratio (aspect ratio of the affected side/aspect ratio of the unaffected side), and Hausdorff distance. In addition, the alveolar and palate cleft width was measured at the times of orthopedic plate setting and primary cheiloplasty. The aspect ratio was significantly smaller in the NAM group than in the HP group before the operation. In both groups, the aspect ratio, perimeter ratio, and Hausdorff distance were significantly smaller after the operation than before. The width of the alveolar and palate cleft gap was significantly narrowed in the NAM group, and the cleft gap at the initiation of NAM correlated significantly with the Hausdorff distance after cheiloplasty. We found that NAM improved the form of the naris after primary cheiloplasty and decreased the palate cleft gap more effectively than HP and that the width of the palate cleft gap was correlated with the surgical outcome of the naris.
Authors:
Hiroyoshi Sasaki; Shinji Togashi; Rei Karube; Toru Yanagawa; Shizuo Nakane; Katsuhiko Tabuchi; Naomi Ishibashi; Yoshiko Shinya; Hiroyuki Ito; Kenji Yamagata; Kojiro Onizawa; Koji Adachi; Mitsuru Sekido; Hiroki Bukawa
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-9
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  -     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the *Department of Oral and Maxillofacial Surgery and †Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki; ‡Mathematics Laboratory, General Education and Research Center, Faculty of Engineering, Tokyo Polytechnic University, Tokyo; and §Division of Cerebral Structure, Department of Cerebral Research, National Institute for Physiological Sciences, Okazaki, Japan.
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