Cleft palate treatment has changed dramatically since Stroud was a child. Today, a technique called nasoalveolar molding (NAM) is often the first step. It was for Jack. The NAM involves a custom orthotic device that’s worn in the mouth to help reduce the severity of the cleft palate prior to surgery. It works by gradually shrinking the width of the opening and reshaping the nose while newborn tissues are still soft.
“The use of NAM has nearly eliminated the need for major revision surgeries later in life,” Dr. Marcus said. “However, it’s only available from highly skilled orthodontists. Dr. Santiago helped develop the technique in the 1990s and is considered one of the world’s most experienced NAM specialists.”
Jack wore the NAM device 24/7 for about 12 weeks. When he was three months old, Dr. Marcus repaired his cleft lip. When Jack turned one, Dr. Marcus repaired the opening in the roof of his mouth, and when he was four, Dr. Marcus fixed some muscles near the back of the mouth -- a procedure that will help Jack speak normally.
“New lip reconstruction techniques produce more natural results with minimal scarring,” said Dr. Marcus. “This surgical approach, when combined with NAM, means kids born with cleft lips or palates today need fewer surgeries. And we can offer these treatments at a young age, so most kids don’t even remember having them.”
Jack began seeing specialists at Duke during his first week of life.