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

Abstract

Context: Orofacial clefts are one of the most common congenital birth malformations in the oral and maxillofacial area. Lip reconstruction or cheiloplasty is an important issue for these patients, and is performed around three months of age. Presurgical nasoalveolar molding have become part of the treatment protocol in many cleft centers to improve the treatment outcome and commonly employed to reduce the alveolar segments into proper alignment and to improve nasal symmetry in patients with cleft lip and palate The aim of this article is to review the value of this technique as part of the treatment protocol for infants born with cleft lip and palate. Evidence Acquisition: In this review, the electronic databases ISI, PubMed, and Google Scholar were searched. Articles published from 2000 to 2018 were retrieved and underwent abstract and full-text appraisal. The following search terms were used: "nasoalveolar molding", "cleft lip and palate", "presurgical orthopedics", and "nasal stent". Results: Presurgical nasoalveolar molding 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 that is needed to bring the lip segments together while simplifying the surgical approach for the nose. Conclusions: The primary surgical repair of the lip and nose heals under minimal tension, thereby reducing scar formation and improving the esthetic result. Frequent surgical intervention to achieve the desired esthetic results can be avoided by presurgical nasoalveolar molding.