Details
Category: Volume 08 Issue 09 September 2020
Hits: 1510

Title: Presurgical Nasoalveolar Molding Therapy in Bilateral Cleft Lip and Palate – A Case Report

Authors: Jaziya .Z, Rita Zarina. A, Digesh Balachandran, Fathima .S

 DOI: https://dx.doi.org/10.18535/jmscr/v8i9.18

Abstract

Cleft lip and palate cases require presurgical orthopaedics to achieve the normal alignment of the cleft maxillary segments prior to primary cheiloplasty. Management of the protruding/deviated premaxilla in patients with complete bilateral cleft lip and palate is a challenging problem. Various passive and active methods have been developed for the presurgical orthopaedic treatment. However, most of these treatments are complicated and laborious for the patients, parents and clinicians. This article aims to review the preferable options for the management of bilateral cleft lip and palate in children and to discuss a case report where an active intraoral appliance comprising of two components, that is the acrylic premaxillary and palatine process plates, connected with two elastic chains had been successfully employed and satisfactory results obtained.

Keywords: Cleft lip and palate; Presurgical orthopaedics; Nasoalveolar molding.

References

  1. Kaul R, Jain P, Saha S, Sarkar S. Cleft lip and cleft palate: Role of a pediatric dentist in its management. Int J Pedod Rehabil 2017;2:1-6.
  2. Rivera B, Tobar M, Chianale T, Monti F, Flores P. Presurgical orthopedics in children with cleft palate. Case Report. :6.
  3. Matsuo K, Hirose T. Nonsurgical correction of cleft lip nasal deformity in the early neonate. Ann Acad Med Singapore. 1988 Jul;17(3):358–65.
  4. Grayson BH, Shetye PR. Presurgical nasoalveolar moulding treatment in cleft lip and palate patients. Indian J Plast Surg. 2009 Oct; 42:56-61.
  5. Grayson BH, Cutting CB. Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants born with unilateral and bilateral clefts. Cleft Palate Craniofac J 2001;38:193‑8.
  6. Chavarria C, Gateno J, Spengler A, Teichgraeber J, Xia J. Presurgical nasoalveolar molding therapy for the treatment of bilateral cleft lip and palate: A preliminary study. Cleft Palate Craniofac J. 2006 May; 43(3):321-8.
  7. Carrasco L, Faraggi M, Merino A. Rinoseptoplastía en pacientes fisurados. Rev Otorrinolaringol Cir Cabeza Cuello. 2011; 71(2):171-178.
  8. Delgado-Muñoz M, Herrero E, Romance- García A, Romero-Maroto M. Tratamiento ortopédico prequirúrgico de la fisura palatina con la filosofía de Latham. RCOE. 2005; 10(2):199-204.
  9. Broder H, Chan J, Sischo L, Smith C, Stein M, Van Aalst J. Nasoalveolar Molding: Prevalence of Cleft Centers Offering NAM and Who Seeks It. Cleft Palate Craniofac J. 2012 May;49(3):270-275.
  10. Bitter K. Latham’s appliance for presurgical repositioning of the protruded premaxilla in bilateral cleft lip and palate. J Craniomaxillofac Surg 1992;20:99e110.
  11. Bravo Rivera L, Muñoz Tobar D, Torres Chianale F, Fierro Monti C, Pérez Flores A. Ortopedia prequirúrgica en niños fisurados: Reporte de caso clínico. Odontoestomatología. 2015 May;17(25):53–9.
  12. Maillard S, Retrouvey J-M, Ahmed MK, Taub PJ. Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review. J Oral Maxillofac Res [Internet]. 2017 Sep 30
  13. Lee CTH, Garfinkle JS, Warren SM, Brecht LE, Cutting CB, Grayson BH. Nasoalveolar molding improves appearance of children with bilateral cleft lip-cleft palate. Plast Reconstr Surg. 2008 Oct;122(4):1131–7.
  14. Grabowski R, Gundlach K, Kopp H, Stahl F. Presurgical orthopaedic treatment of newborns with clefts – functional treatment with long-term effects. J Craniomaxillofac Surg. 2006; 34(2):34-44.
  15. Kinouchi N, Horiuchi S, Yasue A, Kuroda Y, Kawai N, Watanabe K, et al. Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity. Saudi Med J. 2018 Feb;39(2):169–78.
  16. Adali N, Mars M, Noar J, Petrie A, Sommerlad B. Presurgical Orthopedics Has No Effect on Archform in Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J. 2012 Jan; 49(1):5-13.
  17. Spengler AL, Chavarria C, Teichgraeber JF, Gateno J, Xia JJ. Presurgical nasoalveolar molding therapy for the treatment of bilateral cleft lip and palate: A preliminary study. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2006 May;43(3):321–8.

Corresponding Author

Jaziya .Z

Junior Resident, Dept. of Pediatric and Preventive Dentistry, Government Dental College, Thiruvananthapuram, Kerala, India