Presurgical nasoalveolar moulding treatment in cleft lip and palate patients

Presurgical infant orthopedics has been employed since 1950 as an adjunctive neonatal therapy for the correction of cleft lip and palate. Most of these therapies did not address deformity of the nasal cartilage in unilateral and bilateral cleft lip and palate as well as the deficiency of the columel...

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Main Authors: Barry H. Grayson, Pradip R. Shetye
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2009-10-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699377
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author Barry H. Grayson
Pradip R. Shetye
author_facet Barry H. Grayson
Pradip R. Shetye
author_sort Barry H. Grayson
collection DOAJ
description Presurgical infant orthopedics has been employed since 1950 as an adjunctive neonatal therapy for the correction of cleft lip and palate. Most of these therapies did not address deformity of the nasal cartilage in unilateral and bilateral cleft lip and palate as well as the deficiency of the columella tissue in infants with bilateral cleft. The nasolaveolar molding (NAM) technique a new approach to presurgical infant orthopedics developed by Grayson reduces the severity of the initial cleft alveolar and nasal deformity. This enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This paper will discuss the appliance design, clinical management and biomechanical principles of nasolaveolar molding therapy. Long term studies on NAM therapy indicate better lip and nasal form, reduced oronasal fistula and labial deformities, 60 % reduction in the need for secondary alveolar bone grafting. No effect on growth of midface in sagittal and vertical plane has been recorded up to the age of 18 yrs. With proper training and clinical skills NAM has demonstrated tremendous benefit to the cleft patients as well as to the surgeon performing the repair.
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spelling doaj-art-04d384a7afd64f1ab273a3ec25e14f7f2025-08-20T03:54:15ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2009-10-0142S56S6110.1055/s-0039-1699377Presurgical nasoalveolar moulding treatment in cleft lip and palate patientsBarry H. Grayson0Pradip R. Shetye1Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, USAInstitute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, USAPresurgical infant orthopedics has been employed since 1950 as an adjunctive neonatal therapy for the correction of cleft lip and palate. Most of these therapies did not address deformity of the nasal cartilage in unilateral and bilateral cleft lip and palate as well as the deficiency of the columella tissue in infants with bilateral cleft. The nasolaveolar molding (NAM) technique a new approach to presurgical infant orthopedics developed by Grayson reduces the severity of the initial cleft alveolar and nasal deformity. This enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This paper will discuss the appliance design, clinical management and biomechanical principles of nasolaveolar molding therapy. Long term studies on NAM therapy indicate better lip and nasal form, reduced oronasal fistula and labial deformities, 60 % reduction in the need for secondary alveolar bone grafting. No effect on growth of midface in sagittal and vertical plane has been recorded up to the age of 18 yrs. With proper training and clinical skills NAM has demonstrated tremendous benefit to the cleft patients as well as to the surgeon performing the repair.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699377cleft lip and palatenasoalveolar mouldingpresurgical orthopaedics
spellingShingle Barry H. Grayson
Pradip R. Shetye
Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
Indian Journal of Plastic Surgery
cleft lip and palate
nasoalveolar moulding
presurgical orthopaedics
title Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
title_full Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
title_fullStr Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
title_full_unstemmed Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
title_short Presurgical nasoalveolar moulding treatment in cleft lip and palate patients
title_sort presurgical nasoalveolar moulding treatment in cleft lip and palate patients
topic cleft lip and palate
nasoalveolar moulding
presurgical orthopaedics
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699377
work_keys_str_mv AT barryhgrayson presurgicalnasoalveolarmouldingtreatmentincleftlipandpalatepatients
AT pradiprshetye presurgicalnasoalveolarmouldingtreatmentincleftlipandpalatepatients