Use of nasal retainers in the primary management of cleft lip: Current practices in France

• Published in: Journal of stomatology, oral and maxillofacial surgery oral and maxillofacial surgery, 2024-09, Vol.125 (5), p.101812-101812, Article 101812
• Main Authors: Poulet, Vinciane, Cavallier, Zoé, Vaysse, Frédéric, Lauwers, Frédéric, Prevost, Alice
• Format: Article
• Language: English
• Subjects: Cleft lip; Cleft lip closure; Nasal conformation; Nasal retainer; Primary cheilorhinoplasty
• ISSN: 2468-7855; 2468-7855
• DOI: 10.1016/j.jormas.2024.101812

•Nasal retainers are widely used after primary cheilorhinoplasty in France.•Different centers use different protocols for postoperative conformation.•Retainers are generally prescribed for 3–4 months after surgery.•Compliance with post-operative nasal retainers is suboptimal.•Retainer design requires investigation to improve tolerance and thus compliance. The primary surgical management of cleft lip (CL) or cleft lip and palate (CLP) aims to achieve harmonious lip and nasal symmetry while ensuring satisfactory ventilation. Postoperative nasal retainers are commonly used, though both duration of use and conformer type used vary widely. This study aimed to establish an inventory of current practices for primary cheilorhinoplasty and nasal retainer use in France. A survey was sent to surgeons within and outside the French National Clefts and Facial Malformations (MAFACE) network. Questions focused on age when primary cleft closure is performed, retainer types used, conformation duration, and estimated patient compliance. Responses were collected March–July 2023. Thirty-two surgeons responded with substantial variations in practices. For isolated CL, the age for primary cleft closure was 1–6 months, with 28 % performing surgery at 3 months, 12.5 % between 3 and 6 months, 44 % at 6 months. In cases with CLP, 63 % performed simultaneous surgery at 6 months. Two surgeons (6 %) reported preoperative nasoalveolar molding and 30 surgeons (94 %) reported postoperative nasal retainer use. Retainer type used immediately after surgery varied, with equal use of commercial retainers (31 %), silicone sheets (31 %), and in-house retainers (31 %). Duration of retainer prescription was in majority 3–4 months. Notably, 44 % of surgeons reported