Child Development and Rehabilitation Center, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
Department of General Surgery, University of Pittsburg Medical Center Pinnacle, Harrisburg, PA, USA.
Cleft Palate Craniofac J. 2021 Sep;58(9):1142-1149. doi: 10.1177/1055665620981331. Epub 2020 Dec 23.
Oronasal fistulae following palatoplasty may affect patients' quality of life by impacting their ability to eat, speak, and maintain oral hygiene. We aimed to quantify the impact of previous oronasal fistula repair on patients' quality of life using patient-reported outcome psychometric tools.
A cross-sectional study of 8- to 9-year-old patients with cleft palate and/or lip was completed. Patients who had a cleft team clinic between September 2018 and August 2019 were recruited. Participants were divided into 2 groups (no fistula, prior fistula repair). Differences in the individual CLEFT-Q and Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Oral Health scores between the 2 groups were evaluated using a multivariate analysis controlling for Veau classification and syndromic diagnosis.
Sixty patients with a history of cleft palate were included. Forty-two (70%) patients had an associated cleft lip. Thirty-two (53.3%) patients had no history of fistula and 28 (46.7%) patients had undergone a fistula repair. CLEFT-Q Dental, Jaw, and Speech Function were all higher in patients without a history of a fistula repair; however, none of these differences were statistically significant. The COHIP-SF 19 Oral Health score demonstrated a significantly lower score in the fistula group, indicating poorer oral health ( = .05).
One would expect that successful repair of a fistula would result in improved function and patient satisfaction, but the consistent trend toward lower CLEFT-Q scores and significantly increased COHIP-SF 19 Oral Health scores in our study group suggests that residual effects linger and that the morbidity of a fistula may not be completely treated with a secondary correction.
腭裂修复术后发生口鼻瘘可能会影响患者的生活质量，使其进食、说话和保持口腔卫生的能力受损。我们旨在使用患者报告的结果心理测量工具来量化先前口鼻瘘修复对患者生活质量的影响。
对 8 至 9 岁的腭裂和/或唇裂患者进行了一项横断面研究。招募了 2018 年 9 月至 2019 年 8 月期间在腭裂团队诊所就诊的患者。将参与者分为 2 组（无瘘管、先前瘘管修复）。使用多元分析控制 Veau 分类和综合征诊断，评估两组之间 CLEFT-Q 和儿童口腔健康影响简表 19（COHIP-SF 19）口腔健康评分的个体差异。
纳入了 60 例有腭裂病史的患者。42 例（70%）患者有唇裂相关畸形。32 例（53.3%）患者无瘘管史，28 例（46.7%）患者接受过瘘管修复。无瘘管修复史患者的 CLEFT-Q 牙颌和言语功能均较高；然而，这些差异均无统计学意义。COHIP-SF 19 口腔健康评分显示瘘管组的得分明显较低，表明口腔健康状况较差（ =.05）。
人们期望瘘管的成功修复会导致功能和患者满意度的提高，但我们研究组中 CLEFT-Q 评分持续下降且 COHIP-SF 19 口腔健康评分显著增加的趋势表明，残留的影响仍然存在，瘘管的发病率可能无法通过二次矫正完全治愈。
