Presurgical Nasoalveolar Molding: A Narrative Review of Early Management in Newborn Patient With Cleft Lip and Palate

Context: Orofacial clefts are among the most common congenital birth malformations in the oral and maxillofacial area. Lip reconstruction or cheiloplasty is a critical issue for these patients when they are around three months old. Presurgical Nasoalveolar Molding (NAM) has become part of the treatment protocol in many cleft centers to improve the treatment outcome. This procedure is commonly employed to reduce the alveolar segments into proper alignment and improve nasal symmetry in patients with cleft lip and palate. Objective: This article aims to review the value of this technique as part of the treatment protocol for infants born with cleft lip and palate. Data Sources: In this review, the electronic databases of ISI, PubMed, and Google Scholar were searched. Articles published from ۲۰۰۰ to ۲۰۱۸ were retrieved and underwent “abstract” and “full-text” appraisal. The following keywords were used: “Nasoalveolar Molding”, “cleft lip and palate”, “presurgical orthopedics”, and “nasal stent”. Results: Presurgical NAM can reduce the severity of the initial cleft deformity, wherein the bony segments are slowly moved to a more favorable position, lessening the amount of surgical correction needed to bring the lip segments together, while simplifying the surgical approach for the nose. Conclusions: By using presurgical NAM, the primary surgical repair of the lip and nose is performed under minimal tension, thereby reducing scar formation and improving the esthetic results. Also, the frequent surgical intervention to achieve the desired esthetic results can be avoided by this technique.

Keywords:

Cleft lip and palate , Presurgical orthopedics , Nasoalveolar molding