Our Summary

The research paper talks about Nasoalveolar molding (NAM), which is a helpful technique used for treating patients with a cleft lip and palate. The main aim of NAM is to improve the alignment of important parts of the anatomy before the surgical repair of the cleft lip. It involves modifying the position of the alveolar segments (part of the jaw where the teeth sit) and their associated lip elements, as well as the lower lateral cartilages (cartilage in the nose), and the columella (the part separating the nostrils). This process helps to create a suitable base for the cleft lip to be repaired without tension.

FAQs

  1. What is the primary goal of Nasoalveolar molding (NAM) in the treatment of patients with cleft lip and palate?
  2. How does Nasoalveolar molding (NAM) aid in the surgical repair of cleft lip?
  3. What modifications are achieved with Nasoalveolar molding (NAM) in the treatment of cleft lip and palate?

Doctor’s Tip

A doctor might tell a patient that undergoing nasoalveolar molding (NAM) before cleft lip repair surgery can help improve the alignment of critical anatomic elements, such as the alveolar segments and lip elements, to create a suitable platform for tension-free lip repair. NAM can be a helpful tool in achieving optimal results for cleft lip repair.

Suitable For

Patients with unilateral or bilateral cleft lip and palate are typically recommended for cleft lip repair, particularly those who would benefit from nasoalveolar molding (NAM) to improve alignment of critical anatomical elements before surgery. NAM can help modify the position of the alveolar segments, lip elements, lower lateral cartilages, and columella, creating a suitable platform for tension-free lip repair. This treatment is often recommended for infants and young children with cleft lip and palate to optimize the outcomes of surgical repair.

Timeline

Before cleft lip repair:

  • Initial diagnosis of cleft lip and palate
  • Evaluation and consultation with a multidisciplinary team including plastic surgeons, orthodontists, and speech therapists
  • Initiation of nasoalveolar molding (NAM) therapy to improve alignment of critical anatomic elements
  • Regular appointments for adjustments and monitoring progress
  • Preparation for surgical repair, including preoperative evaluations and discussions with the surgical team

After cleft lip repair:

  • Surgical repair of the cleft lip, typically performed between 3-6 months of age
  • Postoperative care and monitoring for complications
  • Follow-up appointments with the surgical team for evaluation of healing and outcomes
  • Continued follow-up with the multidisciplinary team for ongoing management of cleft lip and palate, including speech therapy, orthodontic treatment, and potential future surgeries for optimal outcomes.

What to Ask Your Doctor

  1. What is the recommended age for cleft lip repair surgery?
  2. How many surgeries will be needed to fully repair the cleft lip?
  3. What are the potential risks and complications associated with cleft lip repair surgery?
  4. How long is the recovery process after cleft lip repair surgery?
  5. What kind of scarring can be expected after cleft lip repair surgery?
  6. Will additional treatments, such as speech therapy or dental work, be needed after cleft lip repair surgery?
  7. How successful is nasoalveolar molding (NAM) in improving alignment before cleft lip repair surgery?
  8. Are there any alternative treatments or techniques that could be considered for cleft lip repair?
  9. What is the long-term outlook for a patient after cleft lip repair surgery?
  10. What kind of follow-up care will be needed after cleft lip repair surgery?

Reference

Authors: Kapadia H, Olson D, Tse R, Susarla SM. Journal: Oral Maxillofac Surg Clin North Am. 2020 May;32(2):197-204. doi: 10.1016/j.coms.2020.01.008. Epub 2020 Mar 9. PMID: 32165093