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Effect of nasoalveolar molding therapy on the presurgical correction of maxillary arch and nasal deformity in unilateral cleft lip and palate

Introduction: The surgeons face challenges to restore and align the nasolabial and alveolar structures to the normal state making primary closure of the lip for unilateral cleft lip and palate (UCLP) very difficult. Nasoalveolar molding (NAM) represents a paradigm shift from the traditional methods of presurgical infant orthopedics (PSIO).Objective: To study the outcomes of NAM therapy for the correction of maxillary arch alignment, decreasing the cleft gap severity and improving the nasal esthetics.Material and methods: 12 UCLP infants (age < 1month) were presented for NAM therapy prior to surgical intervention. NAM appliance was constructed as two connected parts; intraoral plate for alveolar molding and nasal stent for nasal molding. Incremental addition and reduction to the appliance were performed to realign the deformed nasoalveolar structure. Measurements of intraoral and nasal casts were made, and statistical analyses were performed to compare the between pre and post NAM measurements.Results: After NAM therapy there was a statistical significant decrease in intersegment distance, midline deviation, alar width. There was also a statistical significant increase in columellar length and angle.Conclusion: By the selective realignment of UCLP nasoalveolar deformity, NAM therapy can achieve a foundation for more esthetic repair under minimal tension.