Cleft lip and palate are common congenital deformities that significantly impact facial anatomy and function, often requiring surgical intervention to correct. Presurgical nasoalveolar molding (NAM) therapy has emerged as an effective nonsurgical approach to improve surgical outcomes by reducing the severity of clefts and molding the alveolar, lip, and nasal segments into more favorable positions. This case report describes the use of NAM therapy in a 15-day-old patient with unilateral cleft lip, palate, and nasal involvement to improve outcomes before cheiloplasty. The patient presented with significant feeding difficulties due to a large palatal cleft. After obtaining parental consent, we conducted a series of procedures to construct and insert an acrylic NAM plate with a retention button and nasal stent, performing weekly adjustments to reshape the alveolar segments and nasal cartilage. Weekly remodeling included selective modifications to the NAM plate, the addition of soft liners, and the use of nasal stents to lift the collapsed nasal cartilages and restore nasal symmetry. Post-treatment results showed a substantial reduction in the cleft lip gap from 17 mm to 6 mm, alveolus gap from 14 mm to 4 mm, left nasal width from 17 mm to 11 mm, and increased left alar height from 4 mm to 7 mm. The successful application of NAM therapy demonstrated its effectiveness in reducing cleft gaps, improving nasal anatomy, and preparing the patient for future surgical interventions with minimal scar formation. This case reinforces the benefits of NAM in reducing cleft deformities, improving feeding function, and avoiding more invasive surgical procedures.
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http://dx.doi.org/10.7759/cureus.69425 | DOI Listing |
Maxillofac Plast Reconstr Surg
January 2025
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
Background: An orofacial cleft significantly impacts the oral health-related quality of life of children and teenagers. Secondary reconstruction is a more complex procedure due to tissue deficiency and scarring. The study aimed to evaluate the use of Pfeifer's wave-line incision method and the rotational flap method in the secondary reconstruction of unilateral lip clefts in patients with unilateral cleft lip and ala nasi aged 5-25 years utilizing anthropometry assessment.
View Article and Find Full Text PDFNeurosurg Focus
January 2025
3ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Objective: Craniofacial clefts, characterized by congenital disruptions in the development of facial and cranial tissues, often present alongside orbital hypertelorism (ORH), an abnormal increase in the interorbital distance. These conditions pose significant challenges in craniofacial surgery due to the complex anatomical and functional considerations involved. This single-center cohort study retrospectively analyzed 22 patients diagnosed with craniofacial cleft syndromes and ORH who were treated at the Craniofacial Centre, Fatima Plastic and Reconstructive Surgery Hospital between July 2016 and October 2023.
View Article and Find Full Text PDFImeta
December 2024
State Key Laboratory of Cultivation Base of Research, Prevention and Treatment for Oral Diseases Nanjing Medical University Nanjing China.
This study investigated pathogenic genes associated with non-syndromic cleft lip with or without cleft palate (NSCL/P) through transcriptome-wide association studies (TWAS). By integrating expression quantitative trait loci (eQTL) data with genome-wide association study (GWAS) data, we identified key susceptibility genes, including . Notably, the variant rs12884809 G>A was associated with an increased risk of NSCL/P by enhancing the binding of the transcription factor ELK1 to the promoter, thereby activating its expression.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
November 2024
Department of Oral and Maxillofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP), Bauru, Sao Paulo, Brazil.
This study aims to evaluate the post-surgical stability of patients with cleft lip and palate that underwent maxillary advancement surgery. The study was conducted by means of cephalometric analysis of the soft tissues in digital radiographs acquired preoperatively, immediate postoperatively and six months after surgery using Dolphin Imaging 11.5 software.
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