Complications During Grayson Presurgical Nasoalveolar Molding Method in Nonsyndromic Infants With Complete Unilateral Cleft Lip and Palate

Gonzalo Andrés Garcés*, María Ignacia Beatriz Moreno Soza, Andrea P. Ormeno, Carolina Macarena Gutiérrez Melis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Introduction: Within the treatment protocols of patients with cleft lip and palate, the nasoalveolar molding (NAM) acquire more followers every day. Their benefits have been well documented, but not equally their complications. The purpose of this study was to describe the complications produced during treatment with Grayson presurgical NAM in nonsyndromic infants with complete unilateral cleft lip and palate. Methods: Bibliographic review on 8 databases using search algorithms. By applying the exclusion and inclusion criteria, 21 articles were detected, which were analyzed in full text. Complication, cause, and solution data were presented in supplemental tables. Results: Complications are related to soft tissues, hard tissues, and those derived from care. Soft tissues: irritation, ulceration, gingival, facial, or nasal bleeding. Candidiasis. An overexpanded nostril creation to improper placement or modifications of the nasal stent at home. The most frequent were lip and cheeks skin irritation by taping, and gingival ulceration due to excessive pressure. Hard tissues: misalignment of alveolar segments and the premature eruption of teeth. Derived from care: inadequate device retention, adherence problems to treatment, poor/excessive care of the caregiver, intolerance to the device, eating problems, breathing, and socioeconomic issues. Conclusions: The main complications occur in soft tissues, related to the retention mechanisms and an inadequate adjustment of the device. The benefits of NAM exceed the complications. It is necessary to know them to avoid any harmful results since they could prolong or stop the treatment, compromising the result. The active collaboration of the family in the insertion and maintenance of the device is crucial for success.
Original languageEnglish
Pages (from-to)2159-2162
Number of pages4
JournalJournal of Craniofacial Surgery
Volume32
Issue number6
DOIs
StatePublished - 1 Sep 2021
Externally publishedYes

Bibliographical note

© 2021 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • Complications
  • Grayson-NAM device
  • presurgical nasoalveolar molding
  • presurgical orthopedics
  • unilateral cleft lip and palate

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