Correction of Unilateral Cleft Lip, Palate and Alveolus by Presurgical Nasoalveolar Molding using Modified Nasal Stent- A Case Report

Abstract

Cleft deformities may lead to psychological problems, dental problems, and aesthetic problems, if left untreated. Hence the management of cleft patients is quite challenging and controversial which involves a multidisciplinary approach including members of various specialties. The Presurgical Nasoalveolar Molding (PNAM) method is an innovative therapy for mitigating the impact of craniofacial deformities. The use of PNAM therapy in a newborn infant is described in this case report. Impressions were taken during the first visit and on the same day lip tape therapy (lip taping) was started using 3M™ Steri Strip™. The Nasoalveolar Molding (NAM) plate was delivered to approximate the cleft alveolus. A modified nasal stent appliance was administered until the cleft gap was decreased to around 4 mm and the cleft lip was repaired through surgery. The use of PNAM with the modified nasal stent appliance showed promise in lowering the amount of the cleft deformity of the lip, palate, and alveolus, with improving nasal aesthetics. When comparing pre-NAM to post-NAM, there was also a considerable reduction in the alveolar defect. In cleft patients, the PNAM-assisted primary reconstruction employing a nasal stent appliance resulted in an overall improvement of the nasolabial complex, enhanced aesthetics, and a reduction in the extent of surgery and surgical operations.