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

LEAP Foundation

Meet Dr. Hobar he is an amazing man and we are lucky to call him our Doctor. We searched and research for the best of the best craniofacial surgeons in the US and amazed to find him in our very backyard, Dallas, TX.  We wanted to tell you about his Non-profit organization LEAP, Life Enhancement Association for People.

LEAP is comprised of volunteer plastic surgeons, urologists, eye surgeons, anesthesiologists, orthodontists, nurses and support staff. Dedicating time, expertise and often their own resources, these volunteers endeavor to bring free surgical care to children and adults born with deformities.

LEAP is a nonprofit, 501(c)(3) organization dedicated to enhancing and enriching the lives of people around the world by providing free specialized medical services in the love of Christ.

Dedicated to the Impossible:Some cases are much too complicated to be done in developing countries. LEAP, known as the ‘medical team of last resort,’ has a special fund to bring patients back to the United States to undergo procedures in a safe and controlled setting. Learn more about the Landmark Fund.

LEAP has a special fund that allows some children with extremely complicated medical deformities to be brought to the U.S. where LEAP doctors and nurses perform the complex reconstructive procedures.

Dedicated to Christ:LEAP is a faith-based Christian organization. The mission for LEAP is to show others the love of Christ through our work, and, hopefully, open the door for others to see Christ. When we go to remote parts of the world and change a life for a person who may have no hope, it is an example of the gospel — grace intervening in an otherwise hopeless situation. When asked why we do this, we tell them “because Christ saved us from a hopeless situation, and His love is available to everyone.”

LEAP provides its services to all patients in need, regardless of religious or political affiliation. LEAP also welcomes volunteers that are not Christian. The only requirement is that the Christian principles that define LEAP are respected and followed in serving others. One of the great joys of LEAP is seeing lives changed both in our patients and their communities, and even in some of our own team members.

Operating Principles

1. LEAP is called to serve others in the love of Christ through the talents of team members.
2. LEAP is dedicated to providing specialized medical services free of charge to the patients and families.
3. LEAP partners with local hospitals and communities to provide care and surgeries to untouched regions of the world.
4. LEAP is dedicated to long-term commitments and relationships established in those countries we serve, partnering with local organizations to assure the greatest continual care for the patients.
5. LEAP is committed to bringing the most gifted and talented medical professionals to ensure the best care possible in the countries we serve.
6. LEAP is determined on training the nations we serve with the latest health care teachings and procedures.

We started LEAP with the idea of going on a single mission trip. God had planted a little seed in my heart and I took a little step forward in faith.  That was it. God did everything else.  That step began in 1991, and 20 years later, totally not as our intention or plan, LEAP is now a global organization that has worked in 17 countries and has touched the lives of over 6,000 patients.  We are blessed to continue to grow and serve others with the love of Christ.

I wanted to find a way to use my skills as a surgeon to help people who didn’t have access to reconstructive surgical care.  So many kids have to grow up with the embarrassment of a facial deformity because they live in a country with little or no surgeons who can perform this type of surgery. We wanted to provide for the people out there who are counting on us.

-Dr. P. Craig Hobar

Founder and Medical Director, LEAP Foundation

Director of International Craniofacial Development,

Medical City Children’s Hospital

Cleft Palate Foundation Publications

Reprinted with  Permission from the Cleft Palate Foundation-available at http://cleftline.org

Fact Sheets:

• For Parents of newborn Babies with Cleft Lip/Palate
• Answers to Common Questions about Scars
• Bonegrafting the Cleft Maxilla
• Choosing a Cleft Palate or Craniofacial Team
• Crouzon Syndrome
• Dealing with Your Insurance Company/ HMO
• Dental Care for a Child with Cleft Lip and Palate
• Financial Assistance
• Letter to Teacher
• Letter to the Parent of a Chil with Cleft
• Moebius Syndrome
• Pierre Robin Syndrome
• Preparing your child for Social Situations
• Positional Plagiocephaly
• Replacing  a missing tooth
• Selected bibiography for Parents
• Speech Development
• Submucous Clefts
• Treacher Collins
• Treatment for Adults

Booklet Summaries:

• Cleft Lip and Palate: The First Four Years
• Cleft Lip and Palate: The School Age years
• As you Get Older: Information for Teens Born with Cleft Lip and Palate
• Cleft Lip and Palate: The adult Patient
• Feeding an Infant with a Cleft
• Cleft Palate and Hearing Loss
• The Genetics of Cleft Lip and Palate:Information for families
• Hemangiomas and Vascular Malformations
• Managing Speech Problems: Physical Treatment of Velopharyngeal Dysfunction
• Audiovisual and Supplemental Resource Catalog
• Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomolies: Summary of Recommendations, American Cleft Palate-Craniofacial Association, May 1993 Rev. 2000