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Revision Rates Of Cleft Lip And Nasal Deformities In Nasoalveolar Molding Versus Lip Adhesion
Ickow, Ilana. Dvoracek, Lucas. Goldstein, Jesse. Grunwaldt, Lorelei. Losee, Joseph E. Schuster, Lindsay. Chen, Wendy. Brooker, Jack.
University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
2019-02-14
Presenter: Ilana Ickow
Affidavit:
This work was never published. The research is all original research.
Director Name: Lindsay Schuster
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Nasoalveolar molding (NAM) and lip adhesion (LA) are two methods used to reduce the severity of a cleft deformity. Previous research has demonstrated that NAM reduces nasal revision rates when compared to a non-NAM sample. However, no studies have compared revision rates in NAM and LA groups. The purpose of this study is to compare revision rates of cleft lip and nasal deformities in patients who underwent NAM versus LA.
This retrospective study analyzed revision rates in 49 patients ages 7-15 who received NAM and 18 patients ages 8-18 who received LA at a single center. These groups were subdivided into NAM + gingivoperiosteoplasty (GPP) (22 subjects), NAM - GPP (27 subjects), LA + GPP (2 subjects), and LA - GPP (16 subjects). Chi square and Fisher's exact test were used to analyze lip, nasal, and lip and nasal revision rates in NAM and LA groups and subgroups.
When comparing overall revision rates in NAM and LA groups, there was no statistically significant difference in revision rates between the two groups (p=0.42). Similarly, there was no statistically significant difference in revision rates between the NAM and LA groups when revision type was considered (p=0.27). Additionally, there was no statistically significant difference in revision rates between the NAM+GPP, NAM-GPP, LA+GPP, and LA-GPP groups (p=0.69).
Future research should evaluate skeletally mature patients and strive to eliminate possible bias due to variations in initial cleft severity, multiple surgeons and surgical techniques used for LA and initial repair, and variable compliance with NAM appliance.
