The nance obturator, a new fixed obturator for patients with cleft palate and fistula.

In patients with fistulas that impair function (e.g., feeding, resonance, intelligibility), obturators are used to improve feeding and reduce nasal air emission by occluding the abnormal opening between the oral and nasal cavities. This report describes a novel method for occluding an anterior palatal fistula in patients with cleft palates. The new design for a fixed obturator is based on the Nance appliance, which was originally used as a space maintainer, but has been redesigned for closing an anterior palatal fistula in a patient with cleft lip and palate. The Nance obturator may be used when the surgical closure of the fistula is not feasible and a removable device is not successful. As it is a fixed device, it does not require remaking with maxillary growth. The new design may also function as a fixed space maintainer to preserve molar anchorage and maxillary transverse width.

A rapid solution to align the severely malpositioned premaxilla in bilateral cleft lip and palate patients.

OBJECTIVE: To describe a laboratory modification of the maxillary cast to make an improved nasoalveolar molding plate used in presurgical orthopedics for infants with bilateral cleft lip and palate. CONCLUSIONS: Modifying the nasoalveolar molding plate may reduce the presurgical treatment time for the bilateral cleft lip and palate patient.