Primary management using a presurgical nasoalveolar molding technique in infants with complete unilateral cleft lip and palate

Considerable progress has recently been made in nose correction techniques in the field of cleft lip surgery. However, surgical repair alone cannot solve the multiple problems associated with wide clefts of the lip and severe deformity of the nose. Presurgical nasoalveolar molding (PNAM) technique for patients with clefts was described by Grayson et al.(1999). This treatment's objectives are non-surgical correction of the nose and alveolar processes, including repositioning the deformed alar cartilages, lengthening of deficient columella, and reduction of the alveolar cleft gap by using Hotz-type palatal molding plates with acrylic nasal stents and surgical adhesive tapes that are applied to the cheeks during the neonatal period. In this paper, we describe our experience with primary management using PNAM in 12 infants with unilateral cleft lip and palate. All cases showed elongation of the columella and reduction of the alveolar cleft gap before primary surgical repair of the lip and nose, which suggested that PNAM is useful for promoting presurgical morphological improvement.