Innovative Presurgical Technique for Cleft Lip and Palate: PLANA and the NoseAlign Device

The "presurgical lip, alveolus, and nose approximation" (PLANA) technique presents a novel method in presurgical infant orthopedics for infants with cleft lip and palate. This approach employs the NoseAlign device along with medical adhesive tapes to help align and support displaced nasolabial tissues without the use of an intraoral plate.

The NoseAlign device, made from medical-grade silicone, features two tubular parts that fit into the nostrils and a connecting band across the columella, along with a wave-shaped lip band that secures to the upper lip using elastic clasps and adhesive tapes. This therapy aims to correct issues such as a collapsed nasal rim, displaced columella, and deviated nasal septum, reducing the need for frequent visits to specialized clinics, which is beneficial for families living far from care centers. The prefabricated device effectively supports both unilateral and bilateral clefts and does not hinder feeding since there is no intraoral plate involved.

Initiating therapy as early as 1 to 2 weeks after birth takes advantage of the soft tissue's natural flexibility to shape the nose before surgery. Although it has some limitations, especially for medially collapsed alveolar segments, the ease of use and broad applicability of PLANA make it a promising option in the field of presurgical infant orthopedics.

Source: Shetye PR. An Innovative Technique of Presurgical Lip, Alveolus, and Nose Approximation (PLANA) for Infants with Clefts. The Journal of Craniofacial Surgery 35(4):p e357-e359, June 2024. | DOI: 10.1097/SCS.0000000000010107

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