Vertikal alveolar uzantılı modifiye nazoalveoler şekillendirme tedavisi: Olgu sunumu

Nazoalveolar şekillendirme (NAŞ) tedavisi ağız dışında burunu ve dudak segmentlerini, ve ağız içinde de alveolar segmentleri seviyelemektedir. Bazı dudak damak yarıklı (DDY) bebeklerde büyük alveolar segmentin mesiali nazal bölgeye doğru yukarı deviasyon göstermektedir. Gelenkesel NAŞ tedavisi ile sınırlı vertikal alveolar yeniden seviyeleme öngörülmektedir. Bu nedenle bu vaka raporunun amacı, vertikal alveolar uzantı (VAU) eklenmiş modifiye NAŞ ile tedavi olan 5 günlük komple dudak damak yarıklı bir bebeğin sunulmasıdır. Gelenksel burun parçasına ek olarak, 0.8’’paslanmaz çelikten VAU bükülüp ağıziçi aygıta eklenmiştir. Bu iki uzantı birbirine zıt kuvvet uygulamaktadır. Burun uzantısı burunu yukarı kaldırırken, alveolar vertikal seviyeleme sağlamak amacıyla VAU alveolar bölgeyi aşağı doğru bastırmaktadır. Ciddi vertikal alveolar deviasyon gösteren DDY’li bebeklerin tedavisinde VAU eklenmiş modifiye NAŞ tedavisi önerilmektedir.

Vertical alveolar stent added modified nasoalveolar molding therapy: Case report

Nasoalveolar molding (NAM) therapy align the deviated nose and separated lip segments extraorally as well as the alveolar segments intraorally. In some infants with cleft the mesial side of the bigger alveolar segment is deviated superiorly to the nasal region. Limited vertical alveolar realignment is expected with traditional NAM. Therefore the aim of this case report is to present a 5-days old infant with complete cleft lip and palate (CLP) who was treated with vertical alveolar stent (VAS) added modified NAM therapy. In addition to the traditional nasal stent, a vertical alveolar stent was bended from 0.8’’ stainless steel wire and applied to the intraoral plate. The two stents work with opposite force direction. While the nasal stent elevated the nasal dome, the VAS depressed the alveolar segment to align the alveolar segments in vertical dimensions. In infants with cleft who presented severe alveolar superior deviation VAS added modified NAM therapy may be recommended.

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