The Burden of Care of Nasoalveolar Molding: An Institutional Experience.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
17 Jan 2024
17 Jan 2024
Historique:
received:
27
06
2023
accepted:
02
12
2023
medline:
17
1
2024
pubmed:
17
1
2024
entrez:
17
1
2024
Statut:
aheadofprint
Résumé
Nasoalveolar molding (NAM) is an early presurgical intervention to facilitate primary cleft lip repair by reducing cleft severity and improving labial and nasal form. However, it continues to be associated with the burden of care that influences access and completion of therapy. The authors, therefore, aim to determine the burden of care of NAM therapy for families seeking treatment at a high-volume urban cleft center. A retrospective study of all patients undergoing primary cleft repair between 2012 and 2020 was performed. Patients were grouped based on whether or not NAM therapy was offered. Variables including physical, psychosocial, and financial factors were assessed. Two hundred and thirty patients underwent primary cleft repair between 2012 and 2020. Of these, 176 patients were indicated for NAM, with 4% discontinuing, and 54 patients did not undergo NAM. The 169 patients who completed NAM had a mean duration of treatment of 13.6±8.8 wks consisting of 15±6 scheduled NAM adjustment visits and 1±1 unscheduled visit made urgently to assess caregiver concerns. The mean travel distance was 28.6±37.1 miles. Eighty-four percent of caregivers were married, and 16% did not have English as a primary language. Though 57% had private insurance, 43% of patients received charity support for their treatment. NAM is a finite presurgical intervention that requires caregivers to participate in patient care for approximately three months of their early life. The decision to pursue NAM should be considered alongside the burden of care for caregivers to complete treatment.
Identifiants
pubmed: 38231199
doi: 10.1097/SCS.0000000000009960
pii: 00001665-990000000-01282
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2024 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
Pradip R. Shetye—Founder/Scientific Advisor, Stockholder, Patents and Royalties: CleftAlign, Inc; Royalties: Wiley. The remaining authors report no conflicts of interest.
Références
Shetye PK, Grayson BH. NasoAlveolar molding treatment protocol in patients with cleft lip and palate. Semin Orthod 2017;23:261–267
Levy-Bercowski D, Abreu A, DeLeon E, et al. Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J 2009;46:521–528
Grayson BH, Garfinkle JS. Early cleft management: the case for nasoalveolar molding. Am J Orthod Dentofacial Orthop 2014;145:134–142
Broder HL, Wilson-Genderson M, Sischo L, et al. Examining factors associated with oral health-related quality of life for youth with cleft. Plast Reconstr Surg 2014;133:828e–834ee
Shay PL, Goldstein JA, Paliga JT, et al. A Comparative cost analysis of cleft lip adhesion and nasoalveolar molding before formal cleft lip repair. Plast Reconstr Surg 2015;136:1264–1271
Sischo L, Clouston SA, Phillips C, et al. Caregiver responses to early cleft palate care: a mixed method approach. Health Psychol 2016;35:474–482
Shetty V, Thakral A, Sreekumar C. Comparison of early onset nasoalveolar molding with patients who presented for molding up to 1 year of age. J Oral Maxillofac Surg 2016;74:811–827
Flores RL, Shetye PR. The Nasoalveolar Molding (NAM) Treatment Protocol. Cleft Palate Craniofac J 2019;56:1124–1125
Saad MS, Fata M, Farouk A, et al. Early progressive maxillary changes with nasoalveolar molding: randomized controlled clinical trial. JDR Clin Trans Res 2020;5:319–331
Singer E, Daskalogiannakis J, Russell KA, et al. Burden of care of various infant orthopedic protocols for improvement of nasolabial esthetics in patients with CUCLP. Cleft Palate Craniofac J 2018;55:1236–1243
Dean RA, Wainwright DJ, Doringo IL, et al. Assessing burden of care in the patient with cleft lip and palate: Factors influencing completion and noncompletion of nasoalveolar molding. Cleft Palate Craniofac J 2019;56:759–765
Wlodarczyk JR, Wolfswinkel EM, Fahradyan A, et al. Nasoalveolar Molding: Assessing the burden of care. J Craniofac Surg 2021;32:574–577
George LK, Gwyther LP. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist 1986;26:253–259
O’Neill G, Ross MM. Burden of care: an important concept for nurses. Health Care Women Int 1991;12:111–121
Alfonso AR, Ramly EP, Kantar RS, et al. What is the burden of care of nasoalveolar molding? Cleft Palate Craniofac J 2020;57:1078–1092
Yarholar LM, Shen C, Wangsrimongkol B, et al. The nasoalveolar molding cleft protocol: Long-term treatment outcomes from birth to facial maturity. Plast Reconstr Surg 2021;147:787e–794e
Grayson BH, Cutting C, Wood R. Preoperative columella lengthening in bilateral cleft lip and palate. Plast Reconstr Surg 1993;92:1422–1423
Matsuo K, Hirose T, Tomono T, et al. Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Plast Reconstr Surg 1984;73:38–51
Altuğ AT. Presurgical nasoalveolar molding of bilateral cleft lip and palate infants: an orthodontist’s Point of View. Turk J Orthod 2017;30:118–125
Snyder HT, Bilboul MJ, Pope AW. Psychosocial adjustment in adolescents with craniofacial anomalies: a comparison of parent and self-reports. Cleft Palate Craniofac J 2005;42:548–555
Pope AW, Tillman K, Snyder HT. Parenting stress in infancy and psychosocial adjustment in toddlerhood: a longitudinal study of children with craniofacial anomalies. Cleft Palate Craniofac J 2005;42:556–559
Klein T, Pope AW, Getahun E, et al. Mothers’ reflections on raising a child with a craniofacial anomaly. Cleft Palate Craniofac J 2006;43:590–597
Bradbury ET, Hewison J. Early parental adjustment to visible congenital disfigurement. Child Care Health Dev 1994;20:251–266
Traube IM, Cutting CB, Grayson BH, et al. Effect of one-stage bilateral cleft lip, nose, and alveolus repair following nasoalveolar molding on the premaxilla position at preadolescence: an 8-year retrospective study. J Craniofac Surg 2023;34:198–201
Sischo L, Chan JW, Stein M, et al. Nasoalveolar molding: Prevalence of cleft centers offering NAM and who seeks it. Cleft Palate Craniofac J 2012;49:270–275
Bous RM, Kochenour N, Valiathan M. A novel method for fabricating nasoalveolar molding appliances for infants with cleft lip and palate using 3-dimensional workflow and clear aligners. Am J Orthod Dentofacial Orthop 2020;158:452–458
Batra P, Gribel BF, Abhinav BA, et al. A comparative evaluation of presurgical infant orthopedics of modified Grayson’s technique with clear aligners incorporating a nasal elevator in patients with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop 2022;162:714–727; Publish Ahead of Print
Batra P, Gribel BF, Abhinav BA, et al. OrthoAligner “NAM”: a case series of presurgical infant orthopedics (PSIO) using clear aligners. Cleft Palate Craniofac J 2020;57:646–655
El-Ashmawi NA, Fayed MMS, El-Beialy A, et al. Evaluation of facial esthetics following NAM versus CAD/NAM in infants with bilateral cleft lip and palate: a randomized clinical trial. Cleft Palate Craniofac J 2023;60:1078–1089
Alperovich M, Frey JD, Shetye PR, et al. Breast milk feeding rates in patients with cleft lip and palate at a North American Craniofacial Center. Cleft Palate Craniofac J 2017;54:334–337
Endriga MC, Speltz ML. Face-to-face interaction between infants with orofacial clefts and their mothers. J Pediatr Psychol 1997;22:439–453
Meleski DD. Families with chronically ill children: a literature review examines approaches to helping them cope. Am J Nurs 2002;102:47–54
Hauenstein EJ. The experience of distress in parents of chronically ill children: Potential or likely outcome? J Clin Child Psychol 1990;19:356–364
Zimmerman CE, Folsom N, Humphries LS, et al. What is the impact of prenatal counseling on postnatal cleft treatment? Multidisciplinary pathway for prenatal orofacial cleft care. J Craniofac Surg 2021;32:947–951
Cohen M, Rosenberg J, Patel PK. Discussion on ultrasound diagnosis of prenatal cleft lip: How does its accuracy affects the family? Prenatal counseling for clefts: The University of Illinois at Chicago, Craniofacial Center’s Protocols and Experience. J Craniofac Surg 2021;32:2471–2474
Mobin SSN, Karatsonyi A, Vidar EN, et al. Is presurgical nasoalveolar molding therapy more effective in unilateral or bilateral cleft lip–cleft palate patients? Plast Reconstr Surg 2011;127:1263–1269
Esmonde NO, Garfinkle JS, Chen Y, et al. Factors associated with adherence to nasoalveolar molding (NAM) by caregivers of infants born with cleft lip and palate. Cleft Palate Craniofac J 2018;55:252–258
Pfeifauf KD, Snyder-Warwick A, Skolnick GB, et al. Primer on state statutory mandates of third-party orthodontic coverage for cleft palate and craniofacial care in the United States. Cleft Palate Craniofac J 2018;55:466–469
Santiago PE, Grayson BH, Cutting CB, et al. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J 1998;35:77–80
Maull DJ, Grayson BH, Cutting CB, et al. Long-term effects of nasoalveolar molding on three-dimensional nasal shape in unilateral clefts. Cleft Palate Craniofac J 1999;36:391–397
Barillas I, Dec W, Warren SM, et al. Nasoalveolar molding improves long-term nasal symmetry in complete unilateral cleft lip-cleft palate patients. Plast Reconstr Surg 2009;123:1002–1006
Clark SL, Teichgraeber JF, Fleshman RG, et al. Long-term treatment outcome of presurgical nasoalveolar molding in patients with unilateral cleft lip and palate. J Craniofac Surg 2011;22:333–336
Lee CT, Grayson BH, Cutting CB, et al. Prepubertal midface growth in unilateral cleft lip and palate following alveolar molding and gingivoperiosteoplasty. Cleft Palate Craniofac J 2004;41:375–380
Pfeifer TM, Grayson BH, Cutting CB. Nasoalveolar molding and gingivoperiosteoplasty versus alveolar bone graft: an outcome analysis of costs in the treatment of unilateral cleft alveolus. Cleft Palate Craniofac J 2002;39:26–29
Rubin MS, Clouston S, Ahmed MM, et al. Assessment of presurgical clefts and predicted surgical outcome in patients treated with and without nasoalveolar molding. J Craniofac Surg 2015;26:71–75
Zuckerman KE, Nelson K, Bryant TK, et al. Specialty referral communication and completion in the community health center setting. Acad Pediatr 2011;11:288–296; PubMed
Zuhaib M, Bonanthaya K, Parmar R, et al. Presurgical nasoalveolar moulding in unilateral cleft lip and palate. Indian J Plast Surg 2016;49:42–52
Uzel A, Alparslan ZN. Long-term effects of presurgical infant orthopedics in patients with cleft lip and palate: A systematic review. Cleft Palate Craniofac J 2011;48:587–595
Papadopoulos MA, Koumpridou EN, Vakalis ML, et al. Effectiveness of pre-surgical infant orthopedic treatment for cleft lip and palate patients: a systematic review and meta-analysis: Pre-surgical orthopedics for cleft lip and palate patients. Orthod Craniofac Res 2012;15:207–236
Shetye PR. Presurgical infant orthopedics. J Craniofac Surg 2012;23:210–211
Shaw WC, Semb G, Nelson P, et al. The Eurocleft Project 1996–2000: Overview. J Craniomaxillofac Surg 2001;29:131–140
Semb G, Enemark H, Friede H, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management. J Plast Surg Hand Surg 2017;51:2–13
Lee CTH, Garfinkle JS, Warren SM, et al. Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate. Plast Reconstr Surg 2008;122:1131–1137
Garfinkle JS, King TW, Grayson BH, et al. A 12-year anthropometric evaluation of the nose in bilateral cleft lip-cleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction. Plast Reconstr Surg 2011;127:1659–1667
Mancini L, Gibson TL, Grayson BH, et al. Three-dimensional soft tissue nasal changes after nasoalveolar molding and primary cheilorhinoplasty in infants with unilateral cleft lip and palate. Cleft Palate Craniofac J 2019;56:31–38
Maliha SG, Kantar RS, Gonchar MN, et al. The effects of nasoalveolar molding on nasal proportions at the time of nasal maturity. Cleft Palate Craniofac J 2021;58:284–289
Mancini L, Avinoam S, Grayson BH, et al. Three-dimensional nasolabial changes after nasoalveolar molding and primary lip/nose surgery in infants with bilateral cleft lip and palate. Cleft Palate Craniofac J 2022;59:475–483
Cussons PD, Murison MSC, Fernandez AEL, et al. A panel based assessment of early versus no nasal correction of the cleft lip nose. Br J Plast Surg 1993;46:7–12
Salyer KE, Genecov ER, Genecov DG. Unilateral cleft lip-nose repair: a 33-year experience. J Craniofac Surg 2003;14:549–558
Kim SK, Cha BH, Lee KC, et al. Primary correction of unilateral cleft lip nasal deformity in Asian patients: Anthropometric evaluation. Plast Reconstr Surg 2004;114:1373–1381
Anderl H, Hussl H, Ninkovic M. Primary simultaneous lip and nose repair in the unilateral cleft lip and palate. Plast Reconstr Surg 2008;121:959–970
Roberts JM, Jacobs A, Morrow B, et al. Current trends in unilateral cleft lip care: A 10-year update on practice patterns. Ann Plast Surg 2020;84:595–601
Magyar D, Nemes B, Pálvölgyi L, et al. The burden of care in nasoalveolar molding treatment in cleft patients. Indian J Plast Surg 2022;55:87–91
Thiruvenkatachari B. Reducing the burden of care for children with clefts: Evaluating the effectiveness of NAsoalveolar Moulding in complete Unilateral non-syndromic Cleft patients (NAMUC Study): A study protocol. Presented at 14th International Cleft Conference. 2022. Accessed January 9, 2024. https://cleft2022.com/wp-content/uploads/2022/07/Cleft%20Book%20of%20Abstracts.pdf.