완전 편측성 구순열 및 불완전 구개열 신생아에서 술전 비치조 정형장치를 이용한 치료 - 증례보고

Treatment using Presurgical Nasoalveolar Molding (PNAM) for a Unilateral Cleft Lip and Palate : Case Report

Cleft lip and palate are the most common congenital facial deformities. Surgical approach alone cannot resolve all the various problems in patients with cleft lip and palate. The concept of presurgical infant orthopedics (PSIO) was first introduced by McNeil to reduce the interval of the cleft and to facilitate surgery. In addition to the traditional PSIO concept, Grayson et al. also reported that a presurgical nasoalveolar molding appliance (PNAM), capable of non-surgically expanding short columella and correcting nasal tip cartilage deformities. The newborn with unilateral cleft lip and palate was referred from the department of Neonatology to the department of Oral & Maxillofacial Surgery(OMFS) for evaluation & treatment. The PNAM was applied 19 days after birth. Then the PNAM was applied for 99 days before the operation and the primary lip and nose repair was performed at 118 days after birth. From the result of this case, we could see that preoperative application of PNAM may provide improvement in the esthetics of nasolabial complex and can minimize the scar tissue after surgery by reducing tension on the surgical area. It can also be helpful to normalize the shape of the nose through correcting of the nasal cartilage and extension of columella.