Presurgical Nasoalveolar Molding of a Unilateral Cleft Lip and Palate Infant -Case Report
The objective of presurgical nasoalveolar molding is to reduce the severity of the initial cleft deformity and to achieve better and more stable results in cleft lip and palate infants. This enables the surgeon to operate a cleft deformity that is of minimal severity with a better treatment outcome. ?n this case report, a unilateral cleft lip and palate infant who was treated with nasoalveolar molding prior to his primary lip and nose closure surgery is presented.
Key Words: Unilateral cleft lip and palate, Nasoalveolar molding, presurgical infant orthopedics
Cleft of the lip, alveolus and palate are the most common congenital malformations…show more content… Presurgical nasoalveolar molding (NAM) of the unilateral cleft infants was developed at New York University Medical Center, Institute of Reconstructive Plastic Surgery by Barry H. Grayson(2). The goals of presurgical nasoalveolar molding in the unilateral infant are to align and approximate the alveolar segments and to correct the malposition of the nasal cartilages. In addition the nasal tip,philtrum,columella and the alar base on the affected side are corrected. These corrections are achieved using a stainless steel (or acyrlic) nasal stent rising from the labial vestibular…show more content… This causes flattening of the nasal tip and inferior displacement of the soft triangle (6). The nasal septum is twisted, slanted, and dislocated out of the vomerine groove, resulting in a twist to the nasal tip (7). The columella is deflected by the deviation of the nasal septum and is vertically deficient on the cleft side. The deformed alar cartilage is dislodged from its normal anatomical position. The medial crus is lower in the columella, with the junction curve of the medial and lateral crus separated from the opposite alar cartilage. Its rests below the opposite cartilage and is flattened , spread, and stretched across the cleft at an obtuse angle