Presurgical Nasoalveolar Molding in a Neonate With Bilateral Cleft Lip and Palate: Report of a Case

Background: Cleft lip and palate as the most common congenital defect of oral cavity possesses a heavy socioeconomic burden for both the child and parents. Nasoalveolar molding (NAM) has received more attention to enhance future facial appearance and function during recent decades

Case Presentation: A 21-day old female neonate was referred with a bilateral cleft lip and palate. Parents complained of frequent bouts of cyanosis during feeding. The infant was a type IV cleft patient which was healthy systematically. An acrylic prosthetic obturator was fabricated which covered the palatal defect with a few millimeters extension into the nasal chamber. After a week, an extraoral tension was added to ensure the posterior protraction of upward and anterior displaced prolabium. Frequent adjustments were performed until the cleft lip operation and afterward to follow the centralization of the lateral maxillary segments and muscular tension changes after the cleft lip operation. The parents were highly satisfied with enhanced appearance and feeding and the patient was followed by the age of one year.

Conclusions: According to the recent promising outcomes of NAM for cleft lip and palate, this method is encouraged to be applied promptly after the birth and to be continued till further provisional or definite corrective surgeries.