Nasoalveolar Molding: Prevalence of Cleft Centers Offering NAM and who Seeks It

• Published in: The Cleft palate-craniofacial journal Vol. 49; no. 3; pp. 270 - 275
• Main Authors: Sischo, Lacey, Chan, Jenny W., Stein, Margot, Smith, Christie, Van Aalst, John, Broder, Hillary L.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2012; American Cleft Palate-Craniofacial Association; SAGE PUBLICATIONS, INC
• Subjects: Alveolar Process - surgery; Biological and medical sciences; Cleft Lip - surgery; Cleft Palate - surgery; Deformities; Female; Health care access; Humans; Male; Medical sciences; Nose - surgery; Otorhinolaryngology. Stomatology; Patient Care Team; Plastic Surgery Procedures - methods; Practice Patterns, Physicians' - statistics & numerical data; Social support; Studies; United States; United States; Canada; insurance; social support; demographic variables; access to care; cleft care; nasoalveolar molding; birth order; Molding; Prevalence; Accessibility; Stomatology; Congenital cleft; Birth; Epidemiology; Congenital disease; Care; Malformation; Social support
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/11-053

Introduction Nasoalveolar molding (NAM) is a treatment option available for early cleft care. Despite the growing debate about the efficacy of nasoalveolar molding, questions remain regarding its prevalence and the demographic characteristics of families undergoing this technique prior to traditional cleft surgery. Objectives To determine the number of teams currently offering nasoalveolar molding and to identify salient clinical and sociodemographic variables in infants and families who choose nasoalveolar molding compared with those who choose traditional cleft care across three well-established cleft centers. Results Via phone surveys, 89% of the U.S. cleft teams contacted revealed that nasoalveolar molding is available at 37% of these centers. Chart reviews and phone correspondence with caregivers indicate that the average distance to the cleft center was 65.5 miles and caregiver age averaged 30.9 ± 5.7 years. Of families who chose nasoalveolar molding, 85% received total or partial insurance coverage. No difference in caregiver education, income, or distance to the clinic between treatment groups was found. On average, infants receiving nasoalveolar molding and cleft surgery had larger clefts and had more clinic visits than infants receiving traditional cleft surgery. Infants who were firstborn and those who did not have other siblings were more likely to receive nasoalveolar molding than were infants who were residing with other siblings. Conclusions Currently more than one-third of U.S. cleft centers offer nasoalveolar molding. Although the cleft size was larger in the nasoalveolar molding group, no treatment group differences in education, income, and distance to the clinic were found.