Palatal fistula risk after primary palatoplasty: a retrospective comparison of humanitarian operations and tertiary hospitals

Daniels, Kimberly; Yu, Emily Yang; Maine, Rebecca; Corlew, Scott; Shi, Bing; Hoffman, William Y.; Gregory, George

doi:10.1016/s0140-6736(15)60832-7

Cited by 16 publications

(12 citation statements)

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“…Several studies in this review consistently report on follow-up, showing that substantial efforts are being made to improve the data output of missions 16 34 35 49–51 61 63. Ten studies reported significant follow-up lengths of more than 6 months and high numbers of patients returning for follow-up were shown 16 34 35 47 49 58 60–62 66. The majority of these missions were engaged in long-term partnerships.…”

Section: Discussionmentioning

confidence: 83%

“…Three of cleft care studies included compared complications between mission patients and patients who underwent similar procedures in a HIC. Results showed substantially higher complication rates in mission patients 34 49 60. One study showed that fistula risk was 15.6 times that for a US cohort 34.…”

Section: Discussionmentioning

confidence: 97%

“…Results showed substantially higher complication rates in mission patients 34 49 60. One study showed that fistula risk was 15.6 times that for a US cohort 34. Maine et al 49 state that complication rates were 20 times higher in the mission cohort compared with a US cohort, independently of whether the surgery was performed by Ecuadorian or American surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Several strategies were implemented to ensure the quality of follow-up. Some missions deployed medical students to assess palate fistulas34 or sent a speech pathologist in-country to review outcomes 61. Others trained local surgeons on follow-up and revision surgery 54.…”

Section: Discussionmentioning

confidence: 99%

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Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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IntroductionShort-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries.MethodsA systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates.ResultsOf 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months’ follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics.ConclusionsEvidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems.PROSPERO registration numberCRD42018099285.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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“…Currently, our fistula rate is <2%, similar to other well-established centers. [35,36] At 5-6 years, lip revision and/or columella lengthening in bilateral clefts may be indicated. Radiographs are usually obtained at this time, allowing assessment of jaw growth, dentition, and alveolar cleft defect.…”

Section: Primary Dentition: 1-7 Yearsmentioning

confidence: 99%

Team Care Protocols for Individuals with Cleft Lip and Palate and Modified Protocols for Developing Countries

Oberoi

Sinha

Devgon

et al. 2018

J Indian Orthod Soc

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Team care is essential to meet the medical, surgical, dental, orthodontic, and psychological needs of individuals with cleft lip and palate. The currently accepted standards of care can only be met if the appropriate specialists work together in the diagnosis and treatment planning, both immediate and long term and in the execution of the various treatments needed. Interdisciplinary team care provides the best overall outcomes for the individual and is also the most efficacious and cost-effective way of meeting the goals of treatment. Interdisciplinary cleft team members should also be a resource in educating parents, students, and other healthcare providers and may participate in research in prevention, interception, and regeneration. We present here the orthodontic protocols of the cleft and craniofacial team at the University of California at San Francisco and provide guidelines for the most essential treatment.

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