2019 Volume 57 Issue 1 Pages 37-44
In infants with a cleft lip and alveolus with / without a cleft palate, treatment with a presurgical nasoalveolar molding (PNAM) technique has an important role in growth guidance of the noso alveolus and palatal morphogenesis, as well as nursing. The structure of the device used and planning differ among institutions and hospitals. At our institution, we utilize hard resin as the base palate and a nasal stent. Furthermore, in addition to daily maintenance of the device, a visit to the clinic every few weeks for adjustment of the appliance for a relatively long period (average 6 to 8 months) is needed until the time of plastic surgery. Thus, parental cooperation is essential, and stress experienced by both parents and their infants must be considered. The purpose of this study was to evaluate our PNAM treatment for cleft infants by surveying their parents. A questionnaire regarding PNAM treat ment was given to the parents of 62 children who underwent plastic surgery following PNAM treat ment at the Department of Dentistry of our medical center for cleft lip and alveolus with / without cleft palate between April 2011 and December 2017. The questionnaire was returned by the parents of 60 (96.8%) patients and the following findings were obtained.
1.PNAM treatment was introduced for affected infants during the relatively long period prior to per formance of a cheiloplasty.
2.Some parents (43.3%) wanted to stop the PNAM treatment, though there was no clear relation of the desire with troubles seen following treatment.
3.A majority of the patients (88.3%) experienced troubles following PNAM treatment, including skin trables caused by use of medicalpapertape (71.7%).
4.Most of the parents (96.7%) were satisfied with the results of PNAM treatment, shown by an an swer of “satisfied” or “moderately satisfied”.
The present findings indicate that PNAM treatment is generally acceptable by parents of infants with a cleft palate. Nevertheless, there is room for improvement of preventive methods in order to avoid troubles caused by that treatment. We intend to develop a readily available support system for such problems.
