Modified nasal alveolar molding appliance for management of cleft lip defect

Nasal alveolar molding is used effectively to reshape the nasal cartilage and mold the maxillary arch before cleft lip repair and primary rhinoplasty. It provides aesthetic and functional benefits of nasal tip and alar symmetry and improved dental arch form. At The Craniofacial Center at the University of Illinois at Chicago, the authors have developed a modification of a nasal alveolar molding appliance previously described in the literature. The key modification is the use of an orthodontic wire from the palatal prosthesis with an acrylic bulb positioned inside the nose, underneath the apex of the alar cartilage, as the nasal stent. This modification allows easier adjustment of the position of the bulb during treatment to achieve a more symmetrical relationship between the nasal cartilages, columella, philtrum, and alveolar segments.