Early or delayed palatoplasty in complete unilateral cleft lip and palate patients? A systematic review of the effects on maxillary growth

Salgado, Karina Rodrigues; Wendt, Andréa Reis; Fagundes, Nathália Carolina Fernandes; Maia, Lucianne Cople; Normando, David; Leão, Patrícia Botelho

doi:10.1016/j.jcms.2019.06.017

Cited by 25 publications

(28 citation statements)

References 47 publications

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“…Likewise, the number of surgeries has an impact on the psychological well-being of the patient. There does not seem to be any consensus on the best time to perform palate closure, where every timing has its own advantages and disadvantages [7,20] . Some studies [15,19,21,22] assumed that the early surgical repair of the cleft palate is responsible for the impaired maxillary growth and concluded that it was better to delay surgical palate repair.…”

Section: Discussionmentioning

confidence: 99%

Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review

Corthouts¹,

Boels²,

Casteele³

et al. 2020

Plast Aesthet Res

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Aim: The purpose of this study was to ascertain the effect of surgical procedures and their timing on maxillofacial growth in unilateral cleft lip and palate (UCLP) patients through a systematic literature review. Methods: In December 2019, a search was conducted in PubMed and Web of Science on the basis of the keywords: "UCLP", "maxillofacial growth" and "facial growth", complemented by a hand search. Results: Eleven articles were included. An important finding was the wide range of treatment protocols. Eight studies performed a multistage procedure, whereas three studies applied a simultaneous repair of cleft lip, palate, and alveolus in a single surgical session. The findings in these articles were based on cephalometric measures. Comparative tables were constructed regarding method of study and time and technique of closure. Conclusion: The results of the articles were conflicting, and it was clear that more research on this subject is necessary. Overall, most studies agreed on the important factor of palatoplasty in maxillofacial growth. The most common finding was a retrusive maxillary growth in comparison to a noncleft control group. This was illustrated by a negative effect on A-point-nasion-B-point. A lot of discussion remains on the effect of lip closure. However,

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Section: Discussionmentioning

confidence: 99%

Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review

Corthouts¹,

Boels²,

Casteele³

et al. 2020

Plast Aesthet Res

View full text Add to dashboard Cite

show abstract

“…Effective treatment of a patient with cleft involves multidisciplinary surgical and non-surgical care from birth to adulthood [4,5]. The treatment outcome is affected by such factors as the extent of the morphological and functional changes involved, the type of cleft as well as the effectiveness of the primary surgery performed, including the surgeon's skills, the choice of the surgical method, and the time and sequence of the surgical repair [6][7][8][9]. Surgical correction is the main premise of the current team approach to clefts management.…”

Section: Introductionmentioning

confidence: 99%

Superior Orbicularis Oris Muscle Activity in Children Surgically Treated for Bilateral Complete Cleft Lip and Palate

Szyszka-Sommerfeld

Machoy

Wilczyński

et al. 2021

JCM

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The aim of this cross-sectional study was to evaluate the electromyographic activity of the superior orbicularis oris muscle both in children surgically treated for bilateral complete cleft lip and palate (BCCLP) as well as in subjects without BCCLP. The study comprised 77 children aged 6.6 to 12.5 years. All the patients with clefts had previously undergone lip and palate surgery. The upper lip electromyographic (EMG) assessments were made with a DAB-Bluetooth device (Zebris Medical GmbH, Germany) at rest, while swallowing saliva, protruding lips and compressing lips. EMG measurements were also made when the subjects produced phonemes /p/, /b/, and /m/ with the vowel /a/. The Mann-Whitney U test was applied to statistically analyze the EMG values. Significantly higher median upper lip EMG activity under working conditions such as swallowing saliva, lip compression, and production of the phoneme /p/ with the vowel /a/ was observed in patients with BCCLP compared to those without a cleft. The results of the study showed that the upper lip muscle activity increases in children with BCCLP when swallowing saliva, compressing lips and during some speech movement tasks. This may be important in the aspect of the effect of surgical lip repair on the craniofacial growth.

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“…The cleft palate repair is very functional in nature, mostly focuses in the quality of speech. 1 The quality of life of a child, and the family, is enhanced by surgical repair at earlier age in terms of functional, aesthetic, psychosocial, and speech issues 4 . Two-flap palatoplasty technique is principally known for having a lower fistula rate and can achieve better levator muscular repositioning 1,5 .…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation Management of Post Palatoplasty in Adolescent: Case Report

Hartono

2021

SPMRJ

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The objective of this study is to report comprehensive physical medicine and rehabilitation management of post-palatoplasty in an adolescent patient. The cleft palate repair is usually done in the first year of life in order to gain optimal speech function. To achieve normal communication development, normal hearing, normal oral and pharyngeal structures, adequate stimulation, and reinforcement from the environment for communication efforts are needed. Patient was assessed comprehensively using The International Classification of Functioning, Disability and Health (ICF) and by perceptual assessment for speech. The results showed that after one month intervention, the perceptions of hypernasality in plosive /b/ and affricates /c/ were found reduced significantly. There was improvement in articulation after one month of intervention.

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Early or delayed palatoplasty in complete unilateral cleft lip and palate patients? A systematic review of the effects on maxillary growth

Cited by 25 publications

References 47 publications

Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review

Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review

Superior Orbicularis Oris Muscle Activity in Children Surgically Treated for Bilateral Complete Cleft Lip and Palate

Rehabilitation Management of Post Palatoplasty in Adolescent: Case Report

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