Presurgical Nasal Molding in a Bilateral Cleft Lip and Palate Patient with Patau Syndrome Using a Novel Bhatia's Hook: A Case Report.

Aims and background: Presurgical nasoalveolar molding (PNAM) is a technique used in cleft lip and palate (CLP) patients to reshape the alveolus, lips, and nostrils before surgical intervention, thereby reducing cleft severity.

Case description: This case report presents a 2-month-old male diagnosed with bilateral CLP and provisional Patau syndrome, characterized by additional anomalies such as right hind limb hypomobility and polysyndactyly. Due to the patient's cardiac condition, conventional nasoalveolar molding (NAM) was contraindicated. Instead, a modified nasal hook named Bhatia's hook was designed and fabricated using stainless steel wire and cold-cure acrylic, designed to mold the nasal structures without alveolar manipulation. The treatment objectives included improving nasal projection, reducing alar width and cleft gap, retracting the premaxilla, and centering the premaxilla. Over a 4-month period, biweekly adjustments led to significant improvements in nasal tip elevation, reduced septal deviation, decreased premaxillary protrusion, and minimized cleft size. Cheiloplasty performed at 6 months resulted in more effective surgical outcomes, including enhanced columella length and external nasal morphology.

Conclusion: The successful management of this case underscores the potential of customized nasal hooks in improving surgical results for CLP patients with complicating factors.

Clinical significance: This modified nasal hook approach offers a viable alternative for nasal molding in patients with complex medical conditions, providing ease of fabrication and consistent force application.

How to cite this article: Bhatia V, Afeefa P, Ratre RK, et al. Presurgical Nasal Molding in a Bilateral Cleft Lip and Palate Patient with Patau Syndrome Using a Novel Bhatia's Hook: A Case Report. Int J Clin Pediatr Dent 2025;18(5):587-590.