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An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding.
Cleft Palate Craniofac J. 2018 05; 55(5):655-663.CP

Abstract

OBJECTIVE

To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction.

DESIGN

Retrospective cohort study.

SETTING

Four cleft centers in North America.

PATIENTS

135 subjects with repaired CUCLP.

METHODS

Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics.

RESULTS

Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences (P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83).

CONCLUSION

The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component.

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Publisher Full Text

Authors+Show Affiliations

Peanchitlertkajorn S
1 University of Texas Southwestern Medical Center, Dallas, TX, USA. 2 Baylor College of Dentistry, Dallas, TX, USA.
Mercado A
3 Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA.
Daskalogiannakis J
4 Department of Orthodontics, University of Toronto, and SickKids Hospital, Toronto, Ontario, Canada.
Hathaway R
5 Department of Pediatrics, Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Russell K
6 Division of Orthodontics, Dalhousie University, and IWK Health Centre, Halifax, Nova Scotia, Canada.
Semb G
7 University of Oslo, Oslo, Norway. 8 Department of Plastic Surgery, Oslo, Norway. 9 Department of Craniofacial Anomalies, University of Manchester, Manchester, United Kingdom.
Shaw W
10 Department of Orthodontics and Dentofacial Development, University of Manchester, Manchester, United Kingdom.
Lamichane M
11 Orthodontic Department, Harvard University, Cambridge, MA, USA. 12 Lancaster Cleft Palate Clinic, Lancaster, PA, USA.
Cohen M
13 Regional Cleft-Craniofacial Program, Cooper University Hospital, Moorestown, NJ, USA.
Long RE
12 Lancaster Cleft Palate Clinic, Lancaster, PA, USA. 14 Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA.

MeSH

ChildCleft LipCleft PalateCombined Modality TherapyEsthetics, DentalFemaleHumansMaleNorth AmericaPalatal ObturatorsPhotographyReconstructive Surgical ProceduresRetrospective StudiesTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29446986

Citation

Peanchitlertkajorn, Supakit, et al. "An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding." The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 55, no. 5, 2018, pp. 655-663.
Peanchitlertkajorn S, Mercado A, Daskalogiannakis J, et al. An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding. Cleft Palate Craniofac J. 2018;55(5):655-663.
Peanchitlertkajorn, S., Mercado, A., Daskalogiannakis, J., Hathaway, R., Russell, K., Semb, G., Shaw, W., Lamichane, M., Cohen, M., & Long, R. E. (2018). An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding. The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 55(5), 655-663. https://doi.org/10.1177/1055665618754947
Peanchitlertkajorn S, et al. An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding. Cleft Palate Craniofac J. 2018;55(5):655-663. PubMed PMID: 29446986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Intercenter Comparison of Nasolabial Appearance Including a Center Using Nasoalveolar Molding. AU - Peanchitlertkajorn,Supakit, AU - Mercado,Ana, AU - Daskalogiannakis,John, AU - Hathaway,Ronald, AU - Russell,Kathleen, AU - Semb,Gunvor, AU - Shaw,William, AU - Lamichane,Manish, AU - Cohen,Marilyn, AU - Long,Ross E,Jr Y1 - 2018/02/15/ PY - 2018/2/16/pubmed PY - 2019/9/19/medline PY - 2018/2/16/entrez KW - Americleft KW - Asher-McDade scale KW - intercenter study KW - nasoalveolar molding KW - nasolabial aesthetics SP - 655 EP - 663 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac. J. VL - 55 IS - 5 N2 - OBJECTIVE: To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction. DESIGN: Retrospective cohort study. SETTING: Four cleft centers in North America. PATIENTS: 135 subjects with repaired CUCLP. METHODS: Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics. RESULTS: Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences (P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83). CONCLUSION: The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component. SN - 1545-1569 UR - https://www.unboundmedicine.com/medline/citation/29446986/An_Intercenter_Comparison_of_Nasolabial_Appearance_Including_a_Center_Using_Nasoalveolar_Molding_ L2 - http://journals.sagepub.com/doi/full/10.1177/1055665618754947?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -

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