PLANA Therapy for Infants With Bilateral Cleft Lip and Palate-Two Case Reports.

Area of Science:

• Craniofacial surgery
• Pediatric plastic surgery
• Cleft lip and palate management

Background:

• Infants with complete bilateral cleft lip and palate, especially with a protruded premaxilla, pose surgical challenges.
• Existing presurgical infant orthopedics (PSIOs) like lip adhesion, Latham appliance, and nasoalveolar molding can increase patient and caregiver burden.
• A need exists for simpler, effective presurgical interventions.

Purpose of the Study:

• To describe the application and outcomes of Presurgical Lip, Nose Alveolar (PLANA) approximation therapy.
• To evaluate PLANA's effectiveness in managing bilateral cleft lip and palate, including cases with significant premaxillary protrusion.
• To highlight PLANA as a less burdensome alternative to conventional PSIOs.

Main Methods:

• PLANA therapy involves medical adhesive lip taping and a series of prefabricated nasal silicone devices.
• This approach aims to retract the premaxilla, enhance nasal tip projection, and promote columellar elongation.
• The method was applied to two infants with bilateral cleft lip and palate, one with mild and one with severe premaxillary protrusion.

Main Results:

• PLANA therapy demonstrated effectiveness in retracting the premaxilla in both cases.
• The therapy promoted nasal tip projection and gradual columellar elongation.
• Variations in premaxillary retraction were observed between infants with and without significant premaxillary protrusion.

Conclusions:

• PLANA therapy is a viable and less burdensome alternative for presurgical management of bilateral cleft lip and palate.
• It effectively achieves presurgical objectives, preparing infants for primary reconstruction.
• PLANA offers a simplified approach with reduced caregiver demands compared to traditional PSIOs.