A novel modification of nasoalveolar molding procedure to enhance ease of use

Cleft lip and palate (CLP) is one of the most common craniofacial birth defects. Its incidence varies according to race, sex and region. As ubiquitous as the condition may be, when it comes to clinical presentation, CLP manifests in a myriad of forms and varieties. The most common clinical presentation is that of a unilateral cleft lip and palate (UCLP). Management of CLP is a challenging proposition but in recent times, the results have become better owing to standardization of treatment protocol and the availability of multidisciplinary teams at specialized cleft centers worldwide. Management of CLP is initiated right from birth with parental counselling followed by presurgical infant orthopedics (PSIO). Nasoalveolar moulding (NAM) is on of the most widely accepted modalities of PSIO and is used to achieve alignment of the cleft alveolar segments into a more ideal relationship prior to the primary lip repair surgery. In its bare essence, NAM uses an acrylic molding plate with selective addition and removal of soft liner to mould the segments into a more ideal position. The molding plate is held in place with elastics which are retained by the use of adherent tapes on the cheek. The use of these tapes on a young infant often leads to tissue irritation and results in reduced compliance and treatment effect. Herein this case report we aim to highlight a novel approach of retaining the molding plate which dispenses with the need of adherent tapes. This technique has the benefit of no tissue irritation, easier application and improved compliance.