Nasoalveolar Molding Program

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Learn more about NAM patient, Elias Orlino.

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).

How Nasoalveolar Molding Helps

Cleft lip and palate often leave the middle part of the nose and the nasal cartilage deformed. Surgery alone is often not enough to provide an aesthetically acceptable correction. The NAM technique takes advantage of the malleability of immature cartilage of the nose and the ability to non-surgically construct the columella (middle part of the nose) through the application of tissue expansion. By the addition of a nasal portion to the molding plate, we can often correct the nasal tip, the base on the affected side, as well as the position of the philtrum and columella.

Team Members

The nasoalveolar molding team provides care in concert with the hospital's cleft palate team.

This group consists of:

  • Surgeons,
  • Pediatric dentists,
  • Orthodontists,
  • Prosthodontists,
  • Psychologists,
  • Therapists,
  • Translators,
  • Geneticists,
  • Case managers,
  • Make-up artists (for some of our older patients).

Support for Care

The children served by this team have all made a wonderful recovery. Many of the services provided by the team are considered to be "non-essential" by insurance providers and other organizations. Consequently, in order to continue to provide these very valuable services to the children, we must look for generous donors for the funds needed to support this important project.

Our team currently provides care for approximately twenty infants each year at our hospital. We hope you will consider supporting our efforts by contributing to the costs to treat these infants.

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Elias Orlino's Story

Elias Orlino was born with cleft lip and palate. His parents brought him to Children's Hospital Los Angeles for Nasoalveolar Molding (NAM) treatment as part of the process to help correct the cleft prior to receiving surgery.

The first video segment below was originally featured in the abc7 Imagine television special in 2006 and features a baby Elias and his family, when they first began his journey with the NAM procedure. (Length 10:56 minutes)

The second video is asp;follow-up interview with the Orlino family, 5 years after Elias underwent the procedure as a baby. His parents were happy to share his story of good health so many years after their son first arrived at our hospital. (Length 01:31 minutes)

Imagine abc7 Segment: Baby Elias Orlino (2006)

Elias Orlino: 5 Years After NAM