Velocardiofacial syndrome (VCFS) is the
most prevalent genetic cause of cleft palate, and these children face a number
of problems. One of these problems is feeding issues, and feeding issues can lead
to failure to thrive. To help address this, there is a prosthetic aid that
helps facilitate feeding for these children and infants. This appliance is
called a feeding obturator, and it restores the separation between the nasal
and oral cavities.
In this article, Chandna, P., Adlakha,
V. K., & Singh, N., (2011) presented a case report of a palatal
obturator placed in an 11-day old healthy infant who presented with a bilateral
cleft lip and palate. The infant demonstrated poor feeding behavior, and had a
non-contributory medical history. No surgery was planned for the infant, so a
cleft palate team (specifically a pediatric dentist, orthodontist, oral
surgeon, prosthodontist, plastic surgeon, pediatrician, otolaryngologist,
psychologist, and a speech therapist) was organized to help the infant. It
was decided that a feeding obturator made of low-density polyethylene was in
order. The team made an impression for the obturator, and constructed the appliance.
Normally, neonatal feeding obturators are
made of acrylic resin for the following reasons: it’s rigid and the
infant can press the nipple against it to feed, it helps position the tongue
directly away from the cleft, it reduces feeding time, nasal regurgitation, and
parents’ anxiety over a child's feeding issues. Yet in this case, instead of
the acrylic obturator, a vacuum tray was ultimately utilized because of
its light weight, moldability, and more precise fit for the ridges and palate. Plus, it also lessened the chances of soft tissue damage because of the softer material.
The infant was held with its face down
while the impression was taken, not only to prevent aspiration in case of
emesis, but also to prevent asphyxiation while the airway was compromised.
Further, the face down position helped to maintain sucking motions during the
making of the impression. This is important because it facilitates moldability.
The parents were taught the correct
feeding procedure as well as how to remove and clean the appliance. At that time
the mother was asked to feed the infant, and it was observed that the child had
success in feeding.
References
Chandna, P., Adlakha, V. K., Sing, N. (2011). Feeding obdurator appliance for an infant with cleft lip and
palate. Journal of the Indian Society of Pedodontics & Preventive Dentistry, 29(1), 71-73. doi:
10.4103/0970-4388.79950.
 |
| This is a view of the infant's bilateral cleft lip and palate (Chandna et al., 2011) |
 |
| This is the cleft palate impression being created (Chandna et al., 2011) |
 |
| This exhibit is the final impression that was made of the cleft palate (Chandna et al., 2011) |
 |
| This exhibit is the stone model that was made (Chandna et al., 2011) |
 |
| This is the vacuum former, where the vacuum tray was created (Chandna et al., 2011) |
 |
| This photo exhibits the feeding obturator being worn (Chandna et al., 2011) |
No comments:
Post a Comment