Early Weight Gain in Infants With Cleft Lip and Palate Treated With and Without Nasoalveolar Molding: A Retrospective Study

2018 ◽  
Vol 56 (7) ◽  
pp. 902-907 ◽  
Author(s):  
Shannon M. Woods ◽  
Judah S. Garfinkle ◽  
David A. Covell ◽  
Mansen Wang ◽  
Lauren S. Busch ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Time Window ◽  
Treatment Protocol ◽  
Percentage Weight Gain ◽  
Early Weight Gain ◽  
Significant Difference ◽  
Percentage Weight ◽  
Nasoalveolar Molding

Objective: To assess weight gain of infants with cleft lip and/or palate (CL ± P) treated with nasoalveolar molding (NAM). Design: Retrospective, case–control chart review. Setting: Doernbecher Children’s Hospital, Oregon Health & Science University, Portland, Oregon. Patients, Participants: Infants with nonsyndromic CL ± P and noncleft controls. Interventions: Prior to primary lip surgery, NAM was either included (+NAM) or not included (−NAM) in the cleft treatment protocol. Main Outcome Measure(s): Weight gain and percentage weight gain relative to initial weight were compared among +NAM, −NAM, and control groups from birth to 7 months and from birth to 36 months. Results: Comparing +NAM and −NAM groups, no significant difference in weight or percentage weight gain was found in either time window. Compared to controls, from birth to 7 months, both CL ± P groups weighed less ( P < .001), while percentage weight gain was greater for the +NAM ( P < .001) and did not differ for −NAM. From birth to 36 months relative to controls, weight for +NAM showed no significant difference and −NAM weighed less ( P < .01), while percentage weight gain was greater for both CL ± P groups ( P < .001). Conclusions: Comparisons of CL ± P infants treated with and without NAM showed that with the NAM appliance, despite its added complexity, there was no adverse impact on weight gain. Comparisons to noncleft, control infants suggests that NAM treatment may have a beneficial impact on weight gain.

scholarly journals ASSESSMENT OF PRESURGICAL NASOALVEOLAR MOULDING (PNAM) IN UNILATERAL CLEFT LIP AND PALATE

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Santosh Kumar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Intervention Group ◽  
Control Group ◽  
Width Ratio ◽  
Long Term Effects ◽  
Important Indicator ◽  
Medical College ◽  
Significant Difference ◽  
Nasoalveolar Molding

Background: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of Presurgical Nasoalveolar Molding (PNAM) on Midface symmetry in children treated for CUCLP. Material and Methods: This case-control study was carried out in the Department of Burn and Plastic Surgery at Government Medical College and Hospital, Bettiah, Bihar, India from may 2018 to Dec 2019. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1) initial (2) postsurgical. 30 nasal molding patients and 20 control patients were included. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Results: A statistically significant difference was found for postsurgical nostril height-width ratio (P< .05). No other statistically significant differences were found. Conclusion: Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding

Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance

2020 ◽  
Vol 57 (6) ◽  
pp. 762-769
Author(s):  
Hanieh Hassani ◽  
Jung-Wei Chen ◽  
Wu Zhang ◽  
William Hamra
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Bacterial Count ◽  
Colony Count ◽  
Caries Risk ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Ph Level ◽  
Nasoalveolar Molding

Purpose: The aim of the current study is as follows: (1) to study whether wearing the presurgical nasoalveolar molding appliance (PNAM) had facilitated the establishment of Streptococcus mutans and Lactobacillus ( LB) and to determine other factors including pH and caries susceptibility associated with wearing the PNAM. Methods: Saliva samples of 61 infants (4.5 ± 2.06 months old) were collected from the following 3 groups: PNAM (n = 23), healthy (n = 30), and cleft lip and palate (CLP) without any treatment (n = 8). Saliva samples were assessed using selective agar to enumerate total LB and S mutans and subjected to adenosine triphosphate (ATP)-driven bioluminescence determinations using a luciferin-based assay system, and pH level was evaluated. One-way analysis of variance with least significant difference post hoc test ( P < .05) and Pearson correlation were used to evaluate S mutans, LB, pH, and ATP levels. Results: A total of 63 patients (30 healthy patients, 23 patients with cleft lip/palate who had PNAM appliance and 8 patients with cleft lip/palate who did not use the appliance) were seen in this study. There is a significant difference in pH ( P = .012), LB Caries Risk Test ( P < .001), LB colony count ( P < .001), S mutans Caries Risk Test ( P < .001), and S mutans colony count ( P < .001) among the 3 groups (PNAM > CLP > healthy). The ATP level was not significantly different among the 3 groups. Conclusion: Higher bacterial count and lower pH were found in the PNAM group. Cleft lip and/or palate patients wearing the PNAM appliance are at higher risk for dental caries.

scholarly journals Performance Indices and Physiological Changes in Pearl Guinea Fowls (Numida Meleagris) Supplemented with Molasses through Drinking Water

2016 ◽  
Vol 18 (2) ◽  
pp. 102
Author(s):  
Buhari Habibu ◽  
Nizam Mustapha Ikira ◽  
Moses Ibrahim ◽  
Hajarah Uwale Buhari ◽  
Abdullahi Abdullahi ◽  
...  
Keyword(s):  
Drinking Water ◽  
Weight Gain ◽  
Rectal Temperature ◽  
Feed Consumption ◽  
Haematological Parameters ◽  
Performance Indices ◽  
Percentage Weight Gain ◽  
Numida Meleagris ◽  
Significant Difference ◽  
Percentage Weight

Abstract. The study was aimed at evaluating the performance indices and physiologic changes in pearl guinea fowls (Numida meleagris) supplemented with molasses through drinking water. A total of thirty-two (n=32) day-old pearl guinea fowls raised to 12-week-old were used for the study. The fowls were randomly allocated to two groups (control and experimental) of 16 fowls each, with each having two replicates. Experimental fowls were given 5 mL molasses per litre of drinking water for 8 weeks, while control fowls were given only drinking water. Performance indices which include: feed consumption, water intake and percentage weight gain were measured. Rectal temperature was measured and blood samples were collected to evaluate the changes in haematological parameters, serum triiodothyronine (T3) and thyroxine (T4) concentrations.  Results revealed that the molasses-treated fowls had significantly (P<0.05) higher percentage weight gain, blood total protein, packed cell volume and mean corpuscular volume compared to control. However, the feed consumptionwas significantly lower (P<0.05) in the molasses-treated fowls compared to control. In both groups, rectal temperature increased significantly (P<0.05) during the afternoon hours and was lower (P<0.05) in molasses-treated fowls than control during the evening hours. There was no significant difference in other haematological parameters, serum glucose, T4 and T3 betweengroups. In conclusion, molasses supplementation decreased feed consumption, improved body weight gain and enhanced nutritional status and erythropoiesis in guinea fowls.

Nasal Obstruction in Children With Cleft Lip and Palate: Results of a Cross-Sectional Study Utilizing the NOSE Scale

2018 ◽  
Vol 56 (2) ◽  
pp. 177-186 ◽  
Author(s):  
Rosaline S. Zhang ◽  
Lawrence O. Lin ◽  
Ian C. Hoppe ◽  
Oksana A. Jackson ◽  
David W. Low ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptom Evaluation ◽  
Significant Difference ◽  
History Of ◽  
Nasoalveolar Molding

Objective: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. Design: Retrospective cross-sectional study. Setting: Cleft Lip and Palate Program, Children’s Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey. Interventions: Nasal Obstruction Symptom Evaluation surveys completed at each annual visit. Main Outcome Measures: Composite NOSE and individual symptom scores. Results: Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms ( P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes ( P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery ( P = .006). There was no significant difference ( P > .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding. Conclusions: There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population.

Knowledge and Attitude Among Various Dental Specialities Regarding Nasoalveolar Molding Procedure in Cleft Patients—A Cross-Sectional Study

2021 ◽  
pp. 105566562110174
Author(s):  
Divya Doddamani ◽  
Saraswathi V. Naik ◽  
Archana P. Betur ◽  
Sugandhan Suriyan ◽  
Basappa Nadig
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Orthopedic Procedure ◽  
Dental Practitioners ◽  
Significant Difference ◽  
Knowledge And Attitude ◽  
The Aesthetic ◽  
Nasoalveolar Molding

Background: Nasoalveolar molding (NAM) is a presurgical orthopedic procedure, mainly focusing upon the aesthetic outcome of the treatment goal by reducing the number of reconstructive surgeries performed later for the purpose of esthetics. It was reported a very small proportion of pediatric dentists are providing presurgical intervention and the practice of NAM still side stepping among various dental practitioners. Objectives: The study was aimed to assess the knowledge and attitude among various dental specialties regarding NAM procedure in cleft patients. Materials and Methods: A questionnaire-based cross-sectional survey was carried out among 180 dental professionals (pedodontists, orthodontists, prosthodontists, oral surgeons). A total of 180 questionnaires were prepared, out of which 98 were filled through direct personal interview and 82 were circulated via Google forms. Results were analyzed using chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. Results: There was statistically significant difference in the cumulative knowledge scores between specialty with P < .001; 99% of the participants think one should opt for NAM before cleft lip and palate surgery and 39% participants prefer pedodontists to carry out NAM procedure. Conclusion: Dental specialists in India have a positive attitude toward presurgical orthopedics. Majority of them agreed that there is great improvement in the aesthetic outcomes of surgeries after NAM intervention.

Prepubertal Midface Growth in Unilateral Cleft Lip and Palate following Alveolar Molding and Gingivoperiosteoplasty

2004 ◽  
Vol 41 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Catherine T. H. Lee ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Lawrence E. Brecht ◽  
Wen Yuan Lin
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Permutation Test ◽  
Long Term Effect ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Late Start ◽  
Nasoalveolar Molding

Objectives To examine the long-term effect of nasoalveolar molding and gingivoperiosteoplasty (modified Millard type) on midface growth at prepuberty. Procedures In this retrospective study, 20 consecutive patients with a history of complete unilateral cleft lip and palate were evaluated. Ten patients had nasoalveolar molding and gingivoperiosteoplasty performed at lip closure; 10 control patients had nasoalveolar molding but no gingivoperiosteoplasty because of late start in treatment or poor compliance. A single surgeon (C.B.C.) performed all surgical procedures. Standardized lateral cephalometric radiographs were evaluated at two time periods: T1 at pre–bone-grafting age and T2 at prepuberty age. Superimposition and cephalometric analysis were undertaken to investigate the two groups. Two cephalometric reference planes, sella-nasion and basion-nasion, were used to assess the vertical and sagittal relations of the midface (ANS-PNS). The reference landmarks were procrustes fitted. The mean location and variance of ANS and PNS landmarks were computed. All results were analyzed by permutation test. Results No significant difference in mean location or variance of ANS-PNS in both vertical and sagittal planes at both T1 and T2 periods were found between the two groups (p > .05). Conclusions The results suggested that midface growth in sagittal or vertical planes (up to the age of 9 to 13 years) were not affected by presurgical alveolar molding and gingivoperiosteoplasty (Millard type).

A Comparative Cephalometric Study of Nasoalveolar Molding– and Non-Nasoalveolar Molding–Treated Bilateral Cleft Patients at Early Mixed Dentition Period

2018 ◽  
Vol 56 (5) ◽  
pp. 569-575 ◽  
Author(s):  
Tulasi Nayak ◽  
Krishnamurthy Bonanthaya ◽  
Renu Parmar ◽  
Pritham N. Shetty ◽  
Dipesh D. Rao
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Single Stage ◽  
Mixed Dentition ◽  
Control Group ◽  
Old Patients ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Cephalometric Study ◽  
Nasoalveolar Molding

Objective: To evaluate and compare early maxillary growth in 2 groups of patients with repaired bilateral cleft lip and palate (BCLP) who had and had not received nasoalveolar molding (NAM) therapy in infancy. Hypothesis: Nasoalveolar molding does not have any effect on maxillomandibular growth at the early mixed dentition period. Design: Retrospective study. Patients: The study group consisted of forty-two 7-year-old patients with BCLP—20 in the NAM group and 22 in the no-NAM group. The control group consisted of nineteen 7-year-old noncleft, normal patients. Interventions: Nasoalveolar molding was carried out prior to surgeries in those children who were brought in within 8 weeks of birth. Children brought in later were treated without a presurgical intervention. All patients were treated with a single-stage modified Millard cheiloplasty without gingivoperiosteoplasty. Palatoplasty was done by single-stage Bardach palatoplasty with muscle repositioning. Mean Outcome Measures: Hard tissue and dental cephalometric values measured on lateral cephalograms, recorded at 7 years of age. Results: A comparison of the mean sagittal values showed a statistically significant maxillomandibular retrusion and incisor retroclination of both BCLP groups in comparison to the control group. None of the cephalometric parameters varied statistically between NAM and no-NAM groups. The maxillomandibular relation, lower face height ratio, mandibular plane, and mandibular axis angles did not show statistically significant difference between all 3 groups. Conclusions: On the basis of this study, NAM does not have any effect on maxillomandibular growth at the early mixed dentition period.

scholarly journals Evaluation and Comparison of the Maxillary Palatal Volume of the Unilateral Cleft Lip and Palate Cases Treated with and without Presurgical Naso-Alveolar Molding as Compared to the Non-Cleft Children – A 3D DVT Study

2021 ◽  
Vol 10 (32) ◽  
pp. 2652-2657
Author(s):  
Pallavi Sachin Daigavane (Thombare) ◽  
Sunita Shrivastav ◽  
Priyanka Niranjane ◽  
Rizwan Gilani ◽  
Ranjit Kamble ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Three Dimensions ◽  
Alveolar Volume ◽  
Cross Sectional ◽  
Significant Difference ◽  
Postdoctoral Research ◽  
Timing Of Initiation ◽  
Nasoalveolar Molding

BACKGROUND Cleft individuals have a significant altered growth of the craniofacial structures since birth. The treatments available for infants are mostly associated with controversies regarding timing of initiation, types & timing in surgery, grafting etc. Maxilla is affected in all three dimensions; due to surgery alone or in conjugation with the infant orthopaedics, intrinsic growth retardation or combination of all. Considering the current conflict over the use of pre-surgical nasoalveolar molding (PNAM) and to evaluate the efficacy of PNAM technique, this postdoctoral research was done to compare the maxillary palatal volume in unilateral cleft lip and palate (UCLP) cases treated with and without PNAM as compared to non-cleft individuals. METHODS This is an observational cross-sectional study. The palate alveolar volume was assessed and analysed using 3D-DVT angiography machine. RESULTS There was significant difference between cleft group and non-cleft individuals. The cases treated with PNAM had lesser palatal volume. CONCLUSIONS Restrictive effect on maxilla was evident in PNAM cases, but this altered growth could also be an amalgamation of numerous factors like surgery, infant orthopaedics, and intrinsic growth. Therefore, judicious use, current concepts, and biomechanics of PNAM is the need of an hour. KEY WORDS Maxillary Palatal Volume, Unilateral Cleft Cases, Presurgical Naso-Alveolar Molding, 3D-DVT

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