NAM Device

So we have some exciting news, Dr. Hobar and the Craniofacial Team decided to design and make a NAM Nasoalveolar Molding for Lottie to help prepare her nose and lip ready for surgery. This is not a typical practice for older children, so we are very pleased that Dr. Hobar thinks outside the box and is willing to work extra hard to create this device for Lottie and work with our insurance to prove the medical necessity.  We cannot believe how everything has fallen into place, we are so blessed to have this opportunity to work with such a talented, God driven, and loving team of doctors. Yesterday we were molded for Lottie's NAM, we will be fitted with this device next week.  Read an excerpt from a journal article about the NAM device, we encourage CL/CP parents to research this option for their children and please feel free to contact us with any questions!

"Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. Nasoalveolar molding represents a paradigm shift from the traditional methods of presurgical infant orthopedics. One of the problems that the traditional approach failed to address was the deformity of the nasal cartilages in unilateral, as well as bilateral, clefts of the lip and palate and the deficiency of columella tissue in infants with bilateral clefts.

The Nasoalveolar Molding (NAM) technique utilizes wire and acrylic nasal stents attached to an intraoral denture. This appliance is used to mold the nasal cartilages, premaxilla, and alveolar ridges into normal form and position during the neonatal period. In effect, this presurgical management of the cleft infant is intended to reduce severity of the oronasal deformity prior to surgery.

This technique takes advantage of the malleability of immature nasal cartilage and its ability to maintain a permanent correction of its form. In addition, we demonstrate the ability to nonsurgically elongate the columella in bilateral cleft lip and palate through the application of tissue expansion principles. This is performed by gradual elongation of the nasal stents and the application of forces that are applied to the lip and nose. Utilization of the NAM technique has eliminated surgical scars associated with traditional columella reconstruction, has reduced the number and cost of revision surgical procedures, and has become the standard of care in this Cleft Palate Center." Grayson, B.H., & Maull, D., 2005, Nasoalveolar Molding for Infants Born with Clefts of the Lip, Alveolus, and Palate:Semin Plast Surg. Cleft Lip Repair: Trends and Techniques, November; 19(4): 294–301. doi:  10.1055/s-2005-925902