TY - JOUR
T1 - Comparison of a third surgical protocol for the treatment of unilateral cleft lip and palate
T2 - a multidisciplinary systematic review and meta-analysis
AU - van Roey, V. L.
AU - Versnel, S. L.
AU - Heliövaara, A.
AU - Alaluusua, S.
AU - Tjoa, S. T.H.
AU - Wolvius, E. B.
AU - Mink van der Molen, A. B.
AU - Mathijssen, I. M.J.
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025
Y1 - 2025
N2 - This systematic review and meta-analysis builds upon our previous publication on the outcomes of patients with unilateral cleft lip and palate (UCLP) treated with Oslo protocols (OP; vomerplasty during lip closure vs delayed hard palate closure protocols (DHPCP), comparing the outcomes of these two protocols with those of one-stage palatoplasty protocols (OSPP). A systematic search of the Embase, MEDLINE/PubMed, Web of Science, Cochrane, and Google Scholar databases was conducted until August 2024. In total, 162 articles (156 study groups) were reviewed, including 4040 UCLP patients following OSPP, 1632 following OP, and 791 following DHPCP. The results suggest that intrinsic maxillofacial growth disturbances are common in UCLP patients, regardless of the timing or type of palatal closure. The incidence of velopharyngeal insufficiency was significantly higher in OP (24%) when compared to DHPCP (9%), with OSPP showing an intermediate incidence (14%). However, these findings are of very low certainty due to evident non-reporting bias and limited data. In contrast, OP and OSPP showed lower oronasal fistula (ONF) rates (7% for OP, 10% for OSPP) compared to DHPCP (20%). Altogether, OSPP and OP are favoured over DHPCP due to the lower incidences of ONF, better overall speech outcomes, and fewer primary surgeries.
AB - This systematic review and meta-analysis builds upon our previous publication on the outcomes of patients with unilateral cleft lip and palate (UCLP) treated with Oslo protocols (OP; vomerplasty during lip closure vs delayed hard palate closure protocols (DHPCP), comparing the outcomes of these two protocols with those of one-stage palatoplasty protocols (OSPP). A systematic search of the Embase, MEDLINE/PubMed, Web of Science, Cochrane, and Google Scholar databases was conducted until August 2024. In total, 162 articles (156 study groups) were reviewed, including 4040 UCLP patients following OSPP, 1632 following OP, and 791 following DHPCP. The results suggest that intrinsic maxillofacial growth disturbances are common in UCLP patients, regardless of the timing or type of palatal closure. The incidence of velopharyngeal insufficiency was significantly higher in OP (24%) when compared to DHPCP (9%), with OSPP showing an intermediate incidence (14%). However, these findings are of very low certainty due to evident non-reporting bias and limited data. In contrast, OP and OSPP showed lower oronasal fistula (ONF) rates (7% for OP, 10% for OSPP) compared to DHPCP (20%). Altogether, OSPP and OP are favoured over DHPCP due to the lower incidences of ONF, better overall speech outcomes, and fewer primary surgeries.
KW - Cleft lip
KW - Cleft palate
KW - Operative surgical procedures
KW - Oral surgical procedures
KW - Treatment outcome
KW - 3126 Surgery, anesthesiology, intensive care, radiology
U2 - 10.1016/j.ijom.2025.04.008
DO - 10.1016/j.ijom.2025.04.008
M3 - Article
AN - SCOPUS:105003557669
SN - 0901-5027
JO - International Journal of Oral and Maxillofacial Surgery
JF - International Journal of Oral and Maxillofacial Surgery
ER -