Nikhil Mahajan
The principle objective of presurgical NAM is to reduce the severity of the initial cleft deformity. This enables the surgeon to enjoy the benefits associated with repair of an infant who presents with a minimal cleft deformity. These goals include lip segments that are almost in contact at rest, symmetrical lower lateral alar cartilages, and adequate nasal mucosal lining, which permits postsurgical retention of the projected nasal tip.There are specific variantions in the procedure of constructing the NAM appliance described in the literature such as the Kernahan Rosenstein Procedure, Latham Millard technique, Modified Georgiade-Latham expansion appliance, Zurich approach and Netherlands approachIn most of these procedures, the constituents in the construction of the NAM appliance are anchorage (embedded) portion, base of the neck ,upper neck portion, nasal bulb with upper and lower lobes and the acrylic plateThere are also associated complications which can be summed up as soft tissue, hard tissue and compliance complications.All of these aspects have been looked upon in detail in this dissertation.
