Orofacial clefts are extremely common birth defects. Orofacial clefts affect a multitude of different areas including feeding, speech, proper tooth development, as well as personality. There are many causes associated with the many different presentations of the birth defect. There have been a multitude of different surgical procedures over time that have dealt with the complications associated with repairing the various clefts. There is no current accepted standard for orofacial cleft repair. In more recent times the focus of the various orofacial clefts procedures have gone from a major procedure where survival was the objective to a more streamline procedure with a man goal of restoring normal human anatomy. Presurgical nasoalveolar molding (PNAM) is more recent procedure that takes advantage of the malleability and rapid growth of facial tissue during the first months of life. This procedure uses a custom acrylic plate that brings the right and left halves of the cleft closer together. This procedure is currently not accepted by all because the long-term effects are unclear.
The aim of this study is to point out the short term successes of the PNAM procedure, compare our results to current published studies, and suggest further study that should be completed. A case report was completed on the first five months of treatment on a bilateral cleft lip/ cleft palate case. The case report followed the patient from birth through the first cleft lip closure surgery. The notes taken at weekly appliance adjustment appointments will be reviewed for information on progress as well as behavior and parent involvement. Pictures were also reviewed in order to review progress as well as surgical procedure. After review of the appointment notes and various pictures from throughout the process it was deemed that this PNAM procedure was a success. It was found that there was an overall increase in symmetry in facial structure as well and an increase in facial tissue. After reviewing pictures of the surgical procedure it can be concluded that the overall process was made easier by the PNAM procedure. It is concluded that the PNAM procedure is extremely successful in the short term but in order to receive more concrete results more cases must be reviewed with future follow-ups in order to see consistent long-term results.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/14362 |
| Date | 22 January 2016 |
| Creators | Alon, Amanda Margaret |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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