The First-Year Follow-Up of a Cleft Lip and Palate Patient Treated With Nasoalveolar Molding (NAM)

Abstract

<jats:p>Abstract The objectives of pre-surgical orthopedics are to allow surgical repair with minimal tension of the involved tissues and less restriction to the craniofacial growth. The aim of this study was to evaluate the benefits of nasoalveolar model (NAM) as a pre-operative therapy in a patient with bilateral cleft lip and palate followed by labioplasty and palatoplasty. A 15-day-old patient underwent orthopedic treatment with NAM. After pre-operative treatment, retraction of the pre-maxilla was observed with reduction of the fissure. Due to the successful effects of NAM treatment the patient had a one-step surgery for lip correction. Six months later, due to lip pressure the fissure was further decreased. After six months, the patient underwent palatoplasty. Both surgeries contributed to the remaining closure of the fissure, which were reduced by half compared to the end of pre-operative treatment. The uses of NAM as a pre-operative treatment approached the alveolar segments, centralized the pre-maxilla, decreased the cleft palate resulting in a marked improvement of the arch and provide superior surgical results. In addition, it allows the primary repair of the patient’s lip with asymmetric bilateral fissure in only one-step surgery; in consequence, it will reduce treatment morbidity and decrease cost of treatment.</jats:p>

A Cross-Sectional Study of the Dental Arch Relationship and Palatal Morphology after Cleft Surgery in Italian Children with Unilateral Cleft and Lip Palate

“…It should be applied as soon as possible and worn daily [ 51 ]. In this way, maxillary growth will be stimulated in order to change the growth pattern in patients with an oro-facial cleft [ 44 , 52 ]. However, the long-term benefits of these appliances are still debated [ 53 ].…”

Presurgical Nasoalveolar Molding—Efficacy and Biomechanics in Management of Cleft Lip and Palate: A Review of the Literature

“…Additionally, Oliveira et al found that NAM helps to centralize the premaxilla and reduce the cleft palate, resulting in a significant improvement of the dental arch and providing excellent surgical outcomes. 32 Furthermore, Chour et al found that NAM was helpful in reducing the size of the CLP with better nasal contour. One of the contradictions of NAM is in midface growth for the patient with CLP treated by NAM interpreted as the treatment protocol appeared to have no impact on skeletal and soft tissue facial growth by Rubin et al 14 However, this is a radiographic study, and it measures the cleft patients at the young age in which most of the changes already happened.…”

The Effects of NAM on the Symmetry of the Face and Maxillary Arch in Babies With Unilateral Cleft

“…Since the 1950s, different techniques have been presented to bring soft and hard tissue closer together 3,4 . The nasoalveolar molding (NAM) technique is a treatment modality described by Grayson et al, 5 which seeks to alleviate asymmetries and cleft severity before surgery 6–8 while promoting important modifications on immature nasal cartilage, taking advantage of its malleability 9,10 …”