Presurgical Nasoalveolar Molding in Management of Cleft Lip and Palate

Cleft lip and cleft palate (CLCP) is one of the most common congenital craniofacial disorders caused by incomplete fusion of maxillary, mandibular processes at embryonic stage. Patients born with a cleft deformity generally experience problems with feeding, speech, and hearing. The psychological stresses and social well-being secondary to their aesthetic deformity needs to be considered in the wellbeing of such patients. In the management cleft lip palate repair, the basic approach is towards the restoration of the normal anatomy of the face. This includes the deficient tissue needs to be expanded. Reorganization of mal positioned structures through pressure appliances prior to surgery for better outcome. The new approach of PNAM therapy describes the reduction of the size of the intraoral alveolar cleft through the active molding of the palatine segments through selective modifications in acrylic plate and nasal stents. When there is a close coordination of presurgical PNAM phase and surgical phase in early infancy, this technique can greatly improve esthetic results of cleft conditions.