Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review

• Published in: Journal of cranio-maxillo-facial surgery Vol. 45; no. 6; pp. 995 - 1003
• Main Authors: Reddy, Rajgopal R, Gosla Reddy, Srinivas, Vaidhyanathan, Anitha, Bergé, Stefaan J, Kuijpers-Jagtman, Anne Marie
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-06-2017
• Subjects: Cleft Lip - surgery; Cleft palate; Cleft Palate - surgery; Dentistry; Growth; Humans; Maxillofacial Development; Oral fistula; Orthognathic Surgical Procedures; Speech; Surgery; Surgical procedure; Systematic review; Oral fistula; Systematic review; Speech; Cleft palate; Growth; Surgical procedure
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2017.03.006

Abstract Background The number of surgical procedures to repair a cleft palate may play a role in the outcome for maxillofacial growth and speech. The aim of this systematic review was to investigate the relationship between the number of surgical procedures performed to repair the cleft palate and maxillofacial growth, speech and fistula formation in non-syndromic patients with unilateral cleft lip and palate. Material and methods An electronic search was performed in PubMed/old MEDLINE, the Cochrane Library, EMBASE, Scopus and CINAHL databases for publications between 1960 and December 2015. Publications before 1950—journals of plastic and maxillofacial surgery—were hand searched. Additional hand searches were performed on studies mentioned in the reference lists of relevant articles. Search terms included unilateral , cleft lip and/or palate and palatoplasty . Two reviewers assessed eligibility for inclusion, extracted data, applied quality indicators and graded level of evidence. Results Twenty-six studies met the inclusion criteria. All were retrospective and non-randomized comparisons of one- and two-stage palatoplasty. The methodological quality of most of the studies was graded moderate to low. The outcomes concerned the comparison of one- and two-stage palatoplasty with respect to growth of the mandible, maxilla and cranial base, and speech and fistula formation. Conclusions Due to the lack of high-quality studies there is no conclusive evidence of a relationship between one- or two-stage palatoplasty and facial growth, speech and fistula formation in patients with unilateral cleft lip and palate.