Nasoalveolar Molding Reduces Cleft Lip Surgeries | Loyola Medicine
Tuesday, February 9, 2016

Nasoalveolar Molding Reduces Surgeries for Cleft Lip and Palate Patients

MAYWOOD, Ill. – Patients with complete unilateral and bilateral cleft lip and palate (U/BCLP) who were treated with nasoalveolar molding (NAM) required fewer surgeries and a reduction in overall healthcare costs compared to similar patients who did not have NAM treatment, according to a study in The Journal of Craniofacial Surgery, authored by Parit A. Patel, MD.

Dr. Patel, an assistant professor at Loyola University Chicago Stritch School of Medicine, is a plastic and reconstruction surgeon who specializes in craniofacial surgery and cleft conditions at Loyola University Health System.   

“NAM is a technique that molds the patient’s lip, nose and gums decreasing the width of the cleft before surgery is performed.  This makes the surgery easier to perform and now has been shown to improve outcomes and reduce cost,” says Dr. Patel, who has successfully implanted numerous patients with the device. “Surgery always has a certain element of risk and the use of NAM reduces complications and the overall number of surgeries. This results in a potentially healthier child, which is really the ultimate goal.”

Cleft lip and palate are two of the most common major birth defects. They are usually diagnosed through a pregnancy ultrasound.

A cleft occurs when tissues of the face do not properly join together during development. The cause in most cases is unknown, however, risk factors include smoking during pregnancy, an older mother, obesity and certain medications such as some used to treat seizures. Cleft lip is more common in males while cleft palate is more common in females.  

NAM is an oral plate similar to a retainer that is typically implanted in a baby’s mouth four to five weeks after delivery. NAM helps to correct the deformity  by reducing the size of the cleft before surgery is performed. Surgeries are required to permanently correct a cleft, but the study showed children with the NAM needed fewer surgeries.    

Loyola is one of a few select academic medical centers offering the NAM treatment  to appropriate pediatric cleft patients. The Loyola plastic and reconstructive surgery team performs a full range of reconstructive and cosmetic surgical procedures and has subspecialty expertise in craniofacial surgery, hand surgery, microsurgery and care of difficult to heal wounds.

The article is titled, “Comparative Study of Early Secondary Nasal Revisions and Costs in Patients With Clefts Treated With and Without Nasoalveolar Molding.”  Authors are Parit A. Patel, MD, Marcie S. Rubin, DrPH, MPH, Sean Clouston, PhD, Frank Lalezaradeh, BS, Lawrence E. Brecht, DDS, Court B. Cutting, MD, Pradip R. Sheyte, DDS, MDS, Stephen M. Warren, MD, and Barry H. Grayson, DDS.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.