Comparative Study of Early Secondary Nasal Revisions and Costs in Patients With Clefts Treated With and Without Nasoalveolar Molding Journal Article

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Authors: Patel, P. A.; Rubin, M. S.; Clouston, S.; Lalezaradeh, F.; Brecht, L. E.; Cutting, C. B.; Shetye, P. R.; Warren, S. M.; Grayson, B. H.
Article Title: Comparative Study of Early Secondary Nasal Revisions and Costs in Patients With Clefts Treated With and Without Nasoalveolar Molding
Abstract: The present study aims to determine the risk of early secondary nasal revisions in patients with complete unilateral and bilateral cleft lip and palate (U/BCLP) treated with and without nasoalveolar molding (NAM) and examine the associated costs of care. A retrospective cohort study from 1990 to 1999 was performed comparing the risk of early secondary nasal revision surgery in patients with a CLP treated with NAM and surgery (cleft lip repair and primary surgical nasal reconstruction) versus surgery alone in a private practice and tertiary level clinic. The NAM treatment group consisted of 172 patients with UCLP and 71 patients with BCLP, whereas the non-NAM-prepared group consisted of 28 patients with UCLP and 5 with BCLP. The risk of secondary nasal revision for patients with UCLP was 3% in the NAM group and 21% in the non-NAM group. The risk of secondary nasal revision for patients with BCLP was 7% in the NAM group compared with 40% in the non-NAM group. Using multicenter averages, the non-NAM revision rates were calculated at 37.8% and 48.5% for U/BCLP, respectively. Applying these risks of revision, NAM treatment led to an estimated savings of between $491 and $4893 depending on the type of cleft. In conclusion, NAM can reduce the number of early secondary nasal revision surgeries and, therefore, reduce the overall cost of care.
Journal Title: The Journal of craniofacial surgery
Volume: 26
Issue: 4
ISSN: 1536-3732; 1049-2275
Publisher: Unknown  
Journal Place: United States
Date Published: 2015
Start Page: 1229
End Page: 1233
Language: eng
DOI/URL:

10.1097/SCS.0000000000001729
Notes: JID: 9010410; ppublish