Document Detail


Presurgical nasoalveolar molding in infants with cleft lip and palate.
MedLine Citation:
PMID:  10574667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. In this paper, we present a paradigm shift from the traditional methods of presurgical infant orthopedics. Some of the problems that the traditional approach failed to address include the deformity of the nasal cartilages in unilateral as well as bilateral clefts of the lip and palate and the deficiency of columella tissue in infants with bilateral clefts. The nasoalveolar molding (NAM) technique we describe uses acrylic nasal stents attached to the vestibular shield of an oral molding plate to mold the nasal alar cartilages into normal form and position during the neonatal period. This technique takes advantage of the malleability of immature cartilage and its ability to maintain a permanent correction of its form. In addition, we demonstrate the ability to nonsurgically construct the columella through the application of tissue expansion principles. This construction is performed by gradual elongation of the nasal stents and the application of tissue-expanding elastic forces that are applied to the prolabium. Use of the NAM technique has eliminated surgical columella reconstruction and the resultant scar tissue from the standard of care in this cleft palate center.
Authors:
B H Grayson; P E Santiago; L E Brecht; C B Cutting
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association     Volume:  36     ISSN:  1055-6656     ISO Abbreviation:  Cleft Palate Craniofac. J.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  2000-01-11     Completed Date:  2000-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102566     Medline TA:  Cleft Palate Craniofac J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  486-98     Citation Subset:  D; IM    
Affiliation:
Institute of Reconstructive Surgery at New York University Medical Center, New York City 10016, USA. barry.grayson@nyu.med.edu
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MeSH Terms
Descriptor/Qualifier:
Acrylic Resins
Alveoloplasty / methods
Cleft Lip / surgery*
Cleft Palate / surgery*
Humans
Infant
Infant, Newborn
Nose / abnormalities,  surgery*
Palatal Obturators*
Reconstructive Surgical Procedures / adverse effects,  instrumentation,  methods*
Stents
Chemical
Reg. No./Substance:
0/Acrylic Resins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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