Presurgical nasoalveolar molding in infants with cleft lip and palate.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Grayson, BH; Santiago, PE; Brecht, LE; Cutting, CB

Published Date

  • November 1999

Published In

Volume / Issue

  • 36 / 6

Start / End Page

  • 486 - 498

PubMed ID

  • 10574667

Pubmed Central ID

  • 10574667

International Standard Serial Number (ISSN)

  • 1055-6656

Digital Object Identifier (DOI)

  • 10.1597/1545-1569_1999_036_0486_pnmiiw_2.3.co_2

Language

  • eng

Conference Location

  • United States