The rate of Le Fort I procedure in patients with cleft lip/palate or cleft palate

Good, Phoebe; Padwa, Bonnie L.; Mulliken, John B.

doi:10.1016/j.joms.2004.05.194

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…14 The need for maxillary advancement is largely subjective and currently without standardized criteria, 13,14 which may account for the variability noted in the literature. [14][15][16] Several factors have been thought to contribute to MFH in cleft conditions. Disruption in embryonic fusion pathways and abnormal insertions of facial musculature, 17 as well as sequelae of cleft repair such as scarring.…”

Section: Introductionmentioning

confidence: 99%

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Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Celie

Wlodarczyk

Tapia

et al. 2022

The Cleft Palate Craniofacial Journal

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Midface hypoplasia (MFH) is a long-term sequela of cleft lip and palate repair, and is poorly understood. No study has examined the aggregate data on sagittal growth restriction of the midface following repair of the lip, but not palate, in these patients. A systematic review of 3780 articles was performed. Twenty-four studies met inclusion criteria and 11 reported cephalometric measurements amenable to meta-analysis. Patients with Veau class I-III palatal clefts were included so long as they had undergone only lip repair. Groups were compared against both noncleft and unrepaired controls. Cephalometrics were reported for 326 patients (31.3% female). Noncleft controls had an average SNA angle of 81.25° ± 3.12°. The only patients demonstrating hypoplastic SNA angles were those with unilateral CLP with isolated lip repair (77.4° ± 4.22°). Patients with repaired CL had SNA angles similar to noncleft controls (81.4° ± 4.02°). Patients with unrepaired CLP and CL tended toward more protruding maxillae, with SNA angles of 83.3° ± 4.04° and 87.9° ± 3.11°, respectively. Notably, when comparing SNA angles between groups, patients with CLP with isolated lip repair had significantly more hypoplastic angles compared to those with repaired CL ( P < .0001). Patients with CLP with isolated lip repair were also more hypoplastic than noncleft controls ( P < .0001). In contrast, there was no significant difference between the SNA of patients with repaired CL and controls ( P = .648). We found that cleft lip repair only appeared to contribute to MFH in the setting of concurrent cleft palate pathology, suggesting that scarring from lip repair itself is unlikely to be the predominant driver of MFH development. However, studies generally suffered from inadequate reporting of timing, technique, follow-up time, and cleft severity.

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Section: Introductionmentioning

confidence: 99%

“…14 The need for maxillary advancement is largely subjective and currently without standardized criteria, 13,14 which may account for the variability noted in the literature. 14–16…”

Section: Introductionmentioning

confidence: 99%

Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Celie

Wlodarczyk

Tapia

et al. 2022

The Cleft Palate Craniofacial Journal

View full text Add to dashboard Cite

show abstract

“…13,14 Although a synchronous approach is the most widely used approach for bilateral repairs, current techniques result in a tight upper lip, short midlip height, a retroclined premaxillary segment, and a higher than usual need for surgical maxillary advancement. 15,16 Staged repairs provide a lax upper lip that will not restrict maxillary growth. 11,12…”

Section: Methodsmentioning

confidence: 99%

Gingivosupraperiosteoplasty following Presurgical Maxillary Orthopedics Is Associated with Normal Midface Growth in Complete Unilateral and Bilateral Cleft Patients at Mixed Dentition

Mejia

Wolfe

Murphy

et al. 2021

Plastic &Amp; Reconstructive Surgery

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resurgical treatments to align the alveolar segments before definitive cleft lip repair have been used in various formats for centuries. The Millard-Latham technique for aligning the maxillary segments became popular in the 1960s and involved the use of an active presurgical orthopedic device for a rapid closure of the alveolar segments. 1 Criticism of this and other active techniques includes that it results in significant restriction of maxillary

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Outcomes of Primary Palatoplasty: An Analysis Using the Pediatric Health Information System Database

Jodeh

Nguyen

Rottgers

2019

Plastic &Amp; Reconstructive Surgery

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Background: Previous attempts at reporting oronasal fistula development and secondary speech surgery following cleft palate surgery have been limited to single-center case series. This limitation can be overcome by querying large databases created by health care governing bodies or health care alliances. The authors examined the effect of cleft type and demographic variables on the clinical outcomes. Methods: Data from the Pediatric Health Information System database were queried for patients, aged 6 to 18 months, who had undergone primary palatoplasty between 2004 and 2009. Subsequent repair of an oronasal fistula and/or secondary speech surgery between 2004 and 2015 was identified by procedure codes. Logistic regression models were used to assess the associations between cleft type with oronasal fistula and with secondary speech surgery. Results: Seven thousand three hundred twenty-five patients were identified, and 6.4 percent (n = 468) had a subsequent repair of an oronasal fistula and 18.5 percent (n = 1355) had a secondary speech operation. Adjusted for age, sex, and race, patients with cleft lip and palate have increased odds of oronasal fistula (OR, 5.60; 95 percent CI, 4.44 to 7.07) and secondary speech surgery (OR, 2.32; 95 percent CI, 2.05 to 2.63). Conclusions: Using a large, multi-institution billing database, the authors were able to estimate the prevalence of oronasal fistula and surgically treated velopharyngeal insufficiency following primary palatoplasty in the United States. In addition, the authors demonstrated that patients with isolated cleft palate develop fewer oronasal fistulas and require less secondary speech surgery than patients with cleft lip and palate. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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The rate of Le Fort I procedure in patients with cleft lip/palate or cleft palate

Cited by 4 publications

References 4 publications

Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis

Gingivosupraperiosteoplasty following Presurgical Maxillary Orthopedics Is Associated with Normal Midface Growth in Complete Unilateral and Bilateral Cleft Patients at Mixed Dentition

Outcomes of Primary Palatoplasty: An Analysis Using the Pediatric Health Information System Database

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