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Presurgical nasoalveolar molding in a 4-day-old infant with unilateral cleft lip, alveolus, and palate deformity

By Abin Mathew, Sunil Muddaiah, Jayanth B Subrahmanya, Sanju Somaiah, Balakrishna Shetty and Goutham Reddy

Abstract

Introduction: A four day old male infant was referred to our department. Infant's mother complained of an opening over lip and difficulty in feeding and desires to get it corrected. On clinical examination patient showed complete unilateral cleft lip, alveolus and palate deformity towards the left side. Methods: On the initial visit, lip taping using 1/4inch 3M Steri-strip was applied and instructions were given to parents about lip taping, and advised to continue lip taping for 2 weeks. Initial impressions were taken to fabricate the Presurgical nasoalveolar molding appliance. Intraoral molding plate was made to approximate the maxillary segments. Nasal stent was added to correct the nose deformity. Presurgical impressions were made. Results: Under this pre surgical treatment, the cleft alveolus reduced in size from 13mm to 3mm at the alveolar ridge and palate, respectively. The nasal wing was lifted considerably. Conclusion: Pre-surgical nasoalveolar moulding helped to reduce the cleft gap, improve the arch form, approximate lip segments and distinctly improve the morphology of the nose by correcting flattened nasal wings. This aforementioned correction not only enabled better aesthetic results after surgery but also reduced tissues tension and scar formation post-surgery. Introduction: A four day old male infant was referred to our department. Infant's mother complained of an opening over lip and difficulty in feeding and desires to get it corrected. On clinical examination patient showed complete unilateral cleft lip, alveolus and palate deformity towards the left side. Methods: On the initial visit, lip taping using 1/4inch 3M Steri-strip was applied and instructions were given to parents about lip taping, and advised to continue lip taping for 2 weeks. Initial impressions were taken to fabricate the Presurgical nasoalveolar molding appliance. Intraoral molding plate was made to approximate the maxillary segments. Nasal stent was added to correct the nose deformity. Presurgical impressions were made. Results: Under this pre-surgical treatment, the cleft edges moved closer by 13mm and 3 mm at the alveolar ridge and palate, respectively. The nasal wing was lifted considerably. Conclusion: Pre-surgical nasoalveolar moulding helped to reduce the cleft gap, improve the arch form, approximate lip segments and distinctly improve the morphology of the nose by correcting flattened nasal wings. This aforementioned correction not only enabled better aesthetic results after surgery but also reduced tissues tension and scar formation post-surgery

Topics: Cleft lip, cleft palate, presurgical nasoalveolar molding, Dentistry, RK1-715
Publisher: Wolters Kluwer Medknow Publications
Year: 2018
DOI identifier: 10.4103/apos.apos_128_17
OAI identifier: oai:doaj.org/article:b778994137bc45eeaf0e1aec617b4c7f
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