Hansjorg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY.
J Craniofac Surg. 2022;33(8):2522-2528. doi: 10.1097/SCS.0000000000008790. Epub 2022 Jul 29.
Presurgical infant orthopedic (PSIO) therapy has evolved in both its popularity and focus of treatment since its advent. Nasoalveolar molding, nasal elevators, the Latham appliance, lip taping, and passive plates are the modern treatment options offered by cleft teams. Many cleft surgeons also employ postsurgical nasal stenting (PSNS) after the primary lip repair procedure. The purpose of this study is to examine trends in current PSIO care as well as PSNS for the management of patients with cleft lip and palate. An electronic survey was distributed to cleft team coordinators listed by the American Cleft Palate Association. The survey reported on team setting, provider availability, PSIO offerings, contraindications, and use of PSNS. Descriptive statistics and analyses were performed using MS Excel and SPSS. A total of 102 survey responses were received. The majority of settings were children's specialty hospitals (66%) or university hospitals (27%). Presurgical infant orthopedics was offered by 86% of cleft teams, and the majority of those (68%) provided nasoalveolar molding. Nasal elevators and lip taping are offered at 44% and 53% of centers, respectively. Latham and passive plates are both offered at 5.5% of centers. Most centers had an orthodontist providing treatment. The majority of centers use PSNS (86%). Nasoalveolar molding is the most popular PSIO technique in North American cleft centers followed by the nasal elevator, suggesting that the nasal molding component of PSIO is of critical influence on current treatment practices.
术前婴儿矫形(PSIO)治疗自问世以来,其受欢迎程度和治疗重点都发生了变化。鼻牙槽塑形、鼻提升器、拉瑟姆矫治器、唇贴带和被动板是腭裂团队提供的现代治疗选择。许多腭裂外科医生也在初次唇修复手术后采用术后鼻支架(PSNS)。本研究旨在检查当前 PSIO 护理以及 PSNS 在管理唇腭裂患者方面的趋势。向美国腭裂协会列出的腭裂团队协调员分发了电子调查。该调查报告了团队设置、提供者可用性、PSIO 产品、禁忌症以及 PSNS 的使用情况。使用 MS Excel 和 SPSS 进行了描述性统计和分析。共收到 102 份调查回复。大多数设置是儿童医院(66%)或大学医院(27%)。86%的腭裂团队提供术前婴儿矫形治疗,其中大多数(68%)提供鼻牙槽塑形。鼻提升器和唇贴带分别在 44%和 53%的中心提供。拉瑟姆和被动板在 5.5%的中心提供。大多数中心都有一名正畸医生提供治疗。大多数中心(86%)使用 PSNS。在北美腭裂中心,最受欢迎的 PSIO 技术是鼻牙槽塑形,其次是鼻提升器,这表明 PSIO 的鼻塑形部分对当前的治疗实践具有至关重要的影响。