Nasoalveolar Molding with Active Columellar Lengthening in Severe Bilateral Cleft Lip/Palate: A Clinical Report

Severe bilateral cleft‐lip/palate patients are difficult to manage even if nasoalveolar molding therapy is advocated before surgical repair. A 5‐day‐old male infant with bilateral cleft‐lip‐palate was managed with the nasoalveolar molding technique. Periodic adjustments of the appliance were continued every week to mold the nasoalveolar complex into the desired shape for the 5 months of infancy. The cleft width of 12 mm on the right and 14 mm on the left side was completely reduced, and the absent columella was lengthened to 6 mm with the active molding appliance. The horizontal bar of the nasal stent of the appliance was modified by adding an additional 1 mm layer of resilient liner on the tissue surface to achieve rapid columellar lengthening. In severe bilateral cleft‐lip/palate cases, simple modifications in the appliance can achieve rapid results.