Sistema de Salut de Catalunya
Institut Català de la Salut
[van Roey VL, Ombashi S] Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands. [Pleumeekers MM, Mathijssen IMJ] Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands. Dutch Craniofacial Centre, Erasmus University Medical Centre, Rotterdam, the Netherlands. [Mink van der Molen AB] Department of Plastic and Reconstructive Surgery, UMC Utrecht, University Medical Centre Utrecht, Utrecht, the Netherlands. [Munill M] Servei de Cirurgia Oral i Maxil·lofacial, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-09-27T11:49:01Z
2024-09-27T11:49:01Z
2024-10
Cleft lip; Oral surgical procedures; Treatment outcome
Llavi leporino; Procediments quirúrgics orals; Resultat del tractament
Labio leporino; Procedimientos quirúrgicos orales; Resultado del tratamiento
There is still no unanimous agreement on the optimal surgical protocol(s) for the treatment of unilateral cleft lip and palate (UCLP), and a huge variety of protocols are employed by cleft centres across the world. The aim of this systematic review and meta-analysis was to compare reported patient outcomes of the Oslo protocol (and modifications) (OP) and delayed hard palate closure protocols (DHPCP) from a multidisciplinary perspective. A systematic search of multiple databases was conducted until September 2023. Studies reporting any patient outcomes of these protocols were included. Random-effects meta-analyses were performed for evidence synthesis, including comparisons of results between the types of protocol. The quality of evidence was evaluated using the ROBINS-I tool. In total, 62 articles (42 studies) reporting patients with UCLP were reviewed, involving 1281 patients following the OP and 655 following DHPCP. Equally poor long-term sagittal maxillofacial growth was found, and similar results for velopharyngeal insufficiency and nasolabial appearance. In contrast, OP was associated with a lower rate of oronasal fistulas. Disregarding the scarcity of comparable evidence for some domains, the results of this review, overall, favour OP over DHPCP. However, caution should be taken when interpreting the results on velopharyngeal insufficiency and oronasal fistulas, since the possibility of confounding and other biases remains.
Partially funded by ERN CRANIO (European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose and Throat (ENT) Disorders) in terms of personnel costs for two researchers (V. van Roey, S. Ombashi). ERN CRANIO is funded by the European Union.
Article
Published version
English
Llavi leporí - Cirurgia; Paladar - Malformacions; Protocols clínics; Boca - Cirurgia; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Clinical Protocols; DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Surgery, Plastic; DISEASES::Musculoskeletal Diseases::Jaw Diseases::Jaw Abnormalities::Cleft Palate; DISEASES::Stomatognathic Diseases::Mouth Diseases::Lip Diseases::Cleft Lip; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Oral Surgical Procedures::Orthognathic Surgical Procedures; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::protocolos clínicos; DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía plástica; ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades maxilomandibulares::anomalías maxilomandibulares::fisura palatina; ENFERMEDADES::enfermedades estomatognáticas::enfermedades de la boca::enfermedades de los labios::labio leporino; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos orales::procedimientos quirúrgicos ortognáticos
Elsevier
International Journal of Oral and Maxillofacial Surgery;53(10)
https://doi.org/10.1016/j.ijom.2024.04.003
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
