Nollet Pieter J P M, Katsaros Christos, Van't Hof Martin A, Kuijpers-Jagtman Anne Marie
Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, The Netherlands.
Plast Reconstr Surg. 2005 Oct;116(5):1255-62. doi: 10.1097/01.prs.0000181652.84855.a3.
The goal of this study was to assess determinants for treatment outcome in unilateral cleft lip and palate, evaluated according to the Great Ormond Street London and Oslo (GOSLON) Yardstick and 5-year-index ratings by means of a meta-analysis.
Multiple databases were searched for publications in which patient groups were evaluated by GOSLON ranking or the GOSLON-like 5-year index. From the 15 selected publications, the following background variables could be extracted and were evaluated as determinants for treatment outcome in unilateral cleft lip and palate: year of birth, average age of the patient at the time of GOSLON classification, racial background, presence of Simonart's band, infant orthopedics, palatal closure before the age of 3 versus palatal closure at a later age, bone graft, and number of surgeons.
The total number of patients included in the meta-analysis was 1236. Patients whose soft and hard palate were closed before the age of 3 presented significantly poorer (p = 0.003) GOSLON scores (mean score, 2.9; SD 0.4) than patients whose palate was closed at a later age (mean GOSLON score, 2.3; SD 0.2).
Delayed palatal closure generally results in better dental arch relationships than early palatal closure. Well-designed, randomized clinical trials are required for further investigation of the optimal timing for palatal closure.
本研究的目的是通过荟萃分析，根据伦敦大奥蒙德街和奥斯陆（GOSLON）量表及5年指数评分，评估单侧唇腭裂治疗效果的决定因素。
检索多个数据库，查找通过GOSLON分级或类似GOSLON的5年指数对患者群体进行评估的出版物。从15篇选定的出版物中，可以提取以下背景变量，并将其作为单侧唇腭裂治疗效果的决定因素进行评估：出生年份、GOSLON分类时患者的平均年龄、种族背景、西蒙纳尔带的存在情况、婴儿正畸治疗、3岁前腭裂修复与较晚年龄腭裂修复、骨移植以及外科医生数量。
纳入荟萃分析的患者总数为1236例。3岁前完成软硬腭裂修复的患者GOSLON评分（平均评分2.9；标准差0.4）明显低于较晚年龄完成腭裂修复的患者（平均GOSLON评分2.3；标准差0.2）（p = 0.003）。
与早期腭裂修复相比，延迟腭裂修复通常会产生更好的牙弓关系。需要设计良好的随机临床试验来进一步研究腭裂修复的最佳时机。
