Abstract

Background: Primary surgical repair of the lip and nose usually results in wide scar and reduced nasal esthetic. Presurgical nasoalveolar molding (NAM) aim to reduce the severity of the initial cleft deformity, thereby enabling the surgeon to perform better outcomes. The aim of this case report is to document the long-term (4-year) outcome of NAM and surgical repair of the unilateral cleft lip and palate.

Case presentation: Two days old female neonate with unilateral cleft lip and palate was presented with initial intersegment distance of 8mm. Molding plate was inserted and modified weekly to guide the alveolar cleft segments to the desired position. The nasal stent was attached to the appliance on the 16th day after reducing the cleft gap to 5mm and it was adjusted weekly to mold the nasoalveolar complex into the desired shape. At 3 months of age, the intersegment distance was 3mm and the patient underwent primary surgical repair of the lip and nose. At age of 9 months, a palatal repair was performed.

Result: At the last patient’s follow up visit (at age of 4 years), there were minimal scars on the lips and nose, and all primary teeth had erupted except the upper left lateral incisor.

Conclusion: Nasoalveolar molding is effective in reducing the width of the cleft and improving the nasal architecture.

Key words: case report; nasoalveolar molding; NAM appliance; cleft lip and palate.