A Retrospective Review on the Effects of Nasoalveolar Molding on Infant Weight Gain and Time to Primary Lip Repair in Unilateral and Bilateral Cleft Lip and Palate

Idorenyin E Ndem; Meredith Kugar; Deanna Caruso; Emilie Duchesneau; Chris B Agala; Nina Mehta; John Van Aalst; Jeyhan S Wood

doi:10.1097/SCS.0000000000010257

A Retrospective Review on the Effects of Nasoalveolar Molding on Infant Weight Gain and Time to Primary Lip Repair in Unilateral and Bilateral Cleft Lip and Palate

J Craniofac Surg. 2024 May 15. doi: 10.1097/SCS.0000000000010257. Online ahead of print.

Authors

Idorenyin E Ndem¹, Meredith Kugar¹, Deanna Caruso², Emilie Duchesneau², Chris B Agala³, Nina Mehta⁴, John Van Aalst¹, Jeyhan S Wood¹

Affiliations

¹ Division of Plastic and Reconstructive Surgery.
² Departments of Epidemiology.
³ Surgery.
⁴ School of Medicine, University of North Carolina, Chapel Hill, NC.

PMID: 38747594
DOI: 10.1097/SCS.0000000000010257

Abstract

Background: In patients with severe cleft deformities, nasoalveolar molding (NAM) can improve long-term lip and nasal symmetry by reducing the size of the cleft, better aligning the alveolus, lip, and nose, and making the primary lip repair more predictable. Despite the increasing number of published studies on modified NAM techniques, the effects of NAM on weight gain and time to primary lip repair remain less studied.

Purpose: This study aims to evaluate the effect of NAM on feeding, weight gain, growth velocity, and time to primary lip repair in patients with complete unilateral and bilateral cleft lip and palate (BCLP).

Methods: A retrospective, single-institution review was conducted to identify patients with complete unilateral and BCLP treated between January 2005 and June 2020. The following outcomes were measured: age at the time of lip and palate repairs; weight, height, and BMI on the date of lip repair; and growth velocity. Crude and standardized morbidity ratio-weighted differences in outcome means and 95% confidence intervals were estimated using t tests.

Results: Seventy-one patients were included in the study, 30 of whom underwent NAM. On average, patients treated with preoperative NAM underwent lip repair later than patients who were not treated with NAM. They also had a greater growth velocity and BMI when compared to their non-NAM counterparts. These differences, however, were not statistically significant.

Conclusion: This study explores the relationships between the use of NAM and preoperative weight gain, as well as time to lip repair in patients with complete unilateral and BCLP. Additional studies may be needed to better elucidate the effect of NAM on weight gain and the time required for surgical repair of the cleft lip and palate.