PRESURGICAL NASOALVEOLAR MOULDING.

Cleft lip and/or palate malformations are the most common congenital abnormalities in the craniofacial region and present a serious problem for health delivery systems throughout the world. The condition requires multiple surgical procedures from birth to maturity and frequent outpatient attendances. Many patients suffer impaired facial growth, dental anomalies, speech disorders, poor hearing, and difficulties in psychological wellbeing and social relationships.Presurgicalnasoalveolar moulding consists of selective repositioning by active moulding of the alveolar segments as well as the surrounding soft tissue. Presurgicalnasolaveolarmoulding (PNAM) involves active moulding andrepositioning of the deformed nasal cartilages and alveolarprocesses as well as the lengthening of the deficientcolumella. A basic treatment objective for the cleft lip, alveolus and palate patient is to restore normal anatomy. This includes the nasal components as well. Because of the major hard and soft tissue abnormalities observed in these patients it is highly desirable to restore the correct skeletal, cartilaginous and soft tissue relationships presurgically. This review analyses the concept of nasoalveolar moulding and the evolution of the procedure through the years and its effectiveness in cleft lip/ palate repair.