Nasoalveolar molding (NAM) is a pre-surgical treatment used to improve the final results of surgical repair for cleft lip and cleft palate. Surgical repair alone cannot correct the multiple problems encountered with the deformities that result from clefts of the lip and palate.
The NAM process actually expands tissues prior to surgery. An acrylic orthopedic appliance is used by dentists to approximate the cleft and mold the nose, reducing the amount of surgical correction required during treatment (in the majority of cases, children only need one surgery as opposed to two surgeries under general anesthesia to repair cleft lip and palate). [http://www.chla.org/site/c.ipINKTOAJsG/b.4816661/k.BA38/Nasoalveolar_Molding_Program.htm#.Us2VirSKeSr]
A week after her birth, we had a consultation at Seattle Children's where we met with our Craniofacial team. We originally met with part of the team back in May when we first found out about the cleft. The team included a pediatrician, a nurse and a counselor. At the second meeting, we also got to meet with the plastic surgeon.
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| In a big blue chair ready to take some 3D pictures |
We got a lot of information that day. Once again they talked about the cleft and how it forms. We were finally given a time frame for when the surgeries would take place. The lip would get repaired at around 6 months of age. The palate would be repaired some time between 9 to 12 months. Later down the road, there may be a nose revision at 5 to 6 yrs of age. And an orthodontist will definitely be needed. Another possible surgery could take place in early adolescent where bone will be taken from the hip to add structure to her gums.
A couple days later we returned to meet with the orthodontist that would be creating and overseeing the NAM device. First an impression was taken of her mouth. We were asked to leave the room during this.
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| Aria's impression. No wonder parents are not allowed. |
We left a sleeping baby and returned to a sleeping baby. The doctor and nurses said she did great.
The NAM would take a week to make but during that time they wanted us to start with some taping. The taping will help pull the gap closer together. They gave us Dynacleft tape to start. It was easy to use. Stick on cheek, pull gap closer together, and stick to the other cheek. Once the tape was in place she looked so sad.
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| Dynacleft tape |
There was a lot of information and new steps to her care that we were given. It was a bit overwhelming. We have a new baby. She's the second child. Now must manage two children. Our newborn has a cleft lip and palate and requires special care. A challenging road lays ahead.
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