In-House Computer-Aided Design/Computer-Aided Manufacturing Digital Nasal Stents: An Economical Alternative for Presurgical Nasal Molding.

Abstract

NasoAlveolar molding (NAM) therapy requires an experienced clinician, compliant caregivers, and an infant without underlying medical conditions. In-house computer-aided design and computer-aided manufacturing (CAD/CAM) digital nasal stents (DNS) are an alternative therapy to NAM developed by the author to reduce the nasal deformity before primary reconstruction surgery when NAM is not suitable, but the patient can still benefit from nasal molding. This paper presents the design, construction, and application of the DNS. CAD/CAM technology was used to design and fabricate the DNS device using a resin-based stereolithography apparatus (SLA) 3D printer. The application of DNS in an infant with a cleft lip is described. A series of custom DNS devices was fabricated and delivered with the aid of lip taping. Before primary reconstructive surgery, an improvement in the cleft nasal deformity was achieved using in-house CAD/CAM digital nasal stents. Simultaneous reduction in the alveolar gap was accomplished with the use of lip taping. Presurgical nasal molding with DNS is an effective, efficient, and economical method to improve nasal deformity before primary reconstructive surgery of the lip and nose in an infant with clefts. This DNS device can be an alternative treatment for nasal molding if NAM therapy cannot be performed.