Morphological Basis for the Construction of a Customized Protective Palatal Obturator for Intubation in Pediatric Patients with Cleft Palate
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| Year of publication | 2025 |
| Type | Conference abstract |
| MU Faculty or unit | |
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| Description | Cleft lip and palate are among the most common congenital defects, significantly impacting an infant's quality of life. Anesthesiologic management—particularly intubation—can be challenging due to the anatomical abnormalities, with a high incidence of complications. A protective palatal obturator that covers the oral cavity defect may significantly enhance visualization of the laryngeal inlet, thereby improving intubation conditions. The primary goal of the proposed project is to enhance patient safety during anesthesia and optimize anesthesiologic management by facilitating intubation and protecting surrounding tissues. To achieve this objective, we aim to develop a methodology for designing and manufacturing palatal obturators specifically for use during intubation process. A pilot study was conducted on a cadaver with cleft lip and palate, sourced from the anatomical collection of the Department of Anatomy, Faculty of Medicine, Masaryk University, to evaluate the feasibility of the proposed approach. The cadaver was a male newborn with an atypical cleft lip and palate, including an undeveloped premaxilla. A 3D scan of the upper jaw, including the cleft palate and alveolar process, was performed using an intraoral 3D scanner. A virtual design of the protective obturator was then created. Based on the scan, a mold representing a negative impression of the upper jaw and palatoalveolar structures was printed using a 3D printer to cast the protective obturator. The resulting silicone obturator fit the upper jaw precisely, providing optimal conditions for tissue protection during future intubations. The complete process—from scanning to the preparation of the protective obturator—took approximately 24 hours. A morphological analysis is currently underway, focusing on measuring the palatal dimensions from 3D scans of various cleft types to develop a universal protective obturator. To assess the dimensions of the upper jaw, we are using the method described by Seckel et al. All measurements are performed using an in-house software application, CleftPoint, developed in Python 3.11. Based on patient data, a universal protective obturator will be designed, tailored to cleft type and patient age. |
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