RapidNAM: generative manufacturing approach of nasoalveolar molding devices for presurgical cleft lip and palate treatment

Franz Xaver Bauer; Markus Schönberger; Johannes Gattinger; Markus Eblenkamp; Erich Wintermantel; Andrea Rau; Florian Dieter Güll; Klaus-Dietrich Wolff; Denys J. Loeffelbein

doi:10.1515/bmt-2016-0035

Article

RapidNAM: generative manufacturing approach of nasoalveolar molding devices for presurgical cleft lip and palate treatment

Franz Xaver Bauer , Markus Schönberger , Johannes Gattinger , Markus Eblenkamp , Erich Wintermantel , Andrea Rau , Florian Dieter Güll , Klaus-Dietrich Wolff and Denys J. Loeffelbein

Published/Copyright: February 9, 2017

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From the journal Biomedical Engineering / Biomedizinische Technik Volume 62 Issue 4

Abstract

Nasoalveolar molding (NAM) is an accepted treatment strategy in presurgical cleft therapy. The major drawbacks of the treatment listed in the literature relate to the time of the treatment and the coordination of the required interdisciplinary team of therapists, parents, and patients. To overcome these limitations, we present the automated RapidNAM concept that facilitates the design and manufacturing process of NAM devices, and that allows the virtual modification and subsequent manufacture of the devices in advance, with a growth prediction factor adapted to the patient’s natural growth. The RapidNAM concept involves (i) the prediction of three trajectories that envelope the fragmented alveolar segments with the goal to mimic a harmonic arch, (ii) the extrusion from the larger toward the smaller alveolar segment along the envelope curves toward the harmonic upper alveolar arch, and (iii) the generation of the NAM device with a ventilation hole, fixation pin, and fixation points for the nasal stents. A feasibility study for a vector-based approach was successfully conducted for unilateral and bilateral cleft lip and palate (CLP) patients. A comparison of the modified target models with the reference target models showed similar results. For further improvement, the number of landmarks used to modify the models was increased by a curve-based approach.

Keywords: envelope curves; growth prediction factor; nasal stent; nasoalveolar molding; virtual planning

Corresponding author: Franz Xaver Bauer, MSc, Institute of Medical and Polymer Engineering, Technical University Munich, Boltzmannstraße 15, 85748 Garching, Germany, Phone: +49-(0)-89-289-16715, Fax: +49-(0)-89-289-16702

Acknowledgments

The RapidNAM project is supported by the Zeidler Research Foundation. The authors wish to express their thanks for their financial support.

Ethical statement: This study has been approved by the local ethic committee (approval number: 236:14).
Conflict of interest: All authors declare they have no conflict of interest.

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Received: 2016-2-12

Accepted: 2017-1-5

Published Online: 2017-2-9

Published in Print: 2017-8-28

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Articles in the same Issue

https://doi.org/10.1515/bmt-2016-0035

Keywords for this article

envelope curves; growth prediction factor; nasal stent; nasoalveolar molding; virtual planning