Plastic and reconstructive surgery · 2025
An Early Comparative Analysis of Presurgical Lip, Alveolus, and Nose Approximation and Nasoalveolar Molding.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Multani Neha, Plana Natalie M, Staffenberg David A, Flores Roberto L, Shetye Pradip R
Аннотация
BACKGROUND: This study evaluates the presurgical lip, alveolus, and nose approximation (PLANA) technique as a novel alternative to nasoalveolar molding (NAM). The study hypothesizes that PLANA can achieve comparable nasolabial outcomes to NAM while addressing its limitations, particularly by reducing the burden of care.
METHODS: A retrospective review was conducted on 50 patients with nonsyndromic unilateral or bilateral cleft lip and palate (CLP) treated with either NAM ( n = 28, including 2 treatment discontinuations) or PLANA ( n = 22). The overall physical burden of care was assessed in the full cohort. A subset of 25 patients with complete unilateral cleft lip and palate (PLANA, n = 12; NAM, n = 13) was further analyzed to assess changes in nasolabial anthropometric ratios between the cleft and noncleft side using standardized two-dimensional photographs taken before and after treatment.
RESULTS: The physical burden of care was significantly lower in the PLANA group, with 61.2% fewer total office visits (5.2 versus 13.4; P < 0.001). The PLANA group also showed a 72.19% reduction in transient reversible side effects, such as oral, nasal, and cheek irritations (18.18% [ n = 4] versus 65.38% [ n = 17]; P < 0.001). PLANA achieved a significantly greater improvement in the columellar length ratio (0.53 versus 0.37; P = 0.026), whereas NAM demonstrated a greater increase in the nostril height ratio (0.29 versus 0.39; P = 0.04). No significant differences were observed in nostril width and alar base width ratios, or columellar deviation angle between the groups.
CONCLUSION: These findings suggest that PLANA significantly reduces the burden of care for patients with cleft lip and palate and may offer comparable nasolabial outcomes to NAM.
METHODS: A retrospective review was conducted on 50 patients with nonsyndromic unilateral or bilateral cleft lip and palate (CLP) treated with either NAM ( n = 28, including 2 treatment discontinuations) or PLANA ( n = 22). The overall physical burden of care was assessed in the full cohort. A subset of 25 patients with complete unilateral cleft lip and palate (PLANA, n = 12; NAM, n = 13) was further analyzed to assess changes in nasolabial anthropometric ratios between the cleft and noncleft side using standardized two-dimensional photographs taken before and after treatment.
RESULTS: The physical burden of care was significantly lower in the PLANA group, with 61.2% fewer total office visits (5.2 versus 13.4; P < 0.001). The PLANA group also showed a 72.19% reduction in transient reversible side effects, such as oral, nasal, and cheek irritations (18.18% [ n = 4] versus 65.38% [ n = 17]; P < 0.001). PLANA achieved a significantly greater improvement in the columellar length ratio (0.53 versus 0.37; P = 0.026), whereas NAM demonstrated a greater increase in the nostril height ratio (0.29 versus 0.39; P = 0.04). No significant differences were observed in nostril width and alar base width ratios, or columellar deviation angle between the groups.
CONCLUSION: These findings suggest that PLANA significantly reduces the burden of care for patients with cleft lip and palate and may offer comparable nasolabial outcomes to NAM.