Division of Plastic Surgery, Department of Surgery, Western University, London, Ontario, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Cleft Palate Craniofac J. 2022 Feb;59(2):156-165. doi: 10.1177/1055665621998176. Epub 2021 Mar 8.
To perform a systematic review of the literature to identify the long-term effects of presurgical orthopedic (PSO) device use on patient outcomes.
A comprehensive literature review of Embase and Ovid databases was performed to identify all English-language publications related to unilateral cleft lip and palate, presurgical devices, and patient outcomes. Studies were excluded if they did not report patient outcomes beyond 2 years of age, did not describe the use of a PSO device, were case reports (n < 10), or were purely descriptive studies.
Reported patient outcomes following the use of PSO devices.
Following a review of all articles by 2 independent reviews, 30 articles were selected for inclusion. Overall, there was no reported consensus as to the long-term effects of PSO devices. Furthermore, this study identified that only 10% of published research controlled for confounding factors that could influence the reported results. Confounding factors that were identified included different operating surgeon, different surgical protocols, and different rates of revision surgeries.
Overall, this systematic review identified 2 important conclusions. Firstly, there is no consensus in the literature about the long-term effects of PSO devices on long-term patient outcomes. Secondly, research in this domain is limited by confounding factors that influence the applicability of the reported results.
对文献进行系统回顾,以确定术前矫形(PSO)器械使用对患者结局的长期影响。
对 Embase 和 Ovid 数据库进行全面文献回顾,以确定所有与单侧唇腭裂、术前器械和患者结局相关的英文出版物。如果未报告年龄超过 2 岁的患者结局、未描述 PSO 器械的使用情况、为病例报告(n < 10)或为纯粹描述性研究,则排除研究。
PSO 器械使用后的患者结局报告。
经过两位独立审稿人的全面审查,共选择了 30 篇文章进行纳入。总体而言,PSO 器械的长期效果没有达成共识。此外,本研究还发现,只有 10%的已发表研究控制了可能影响报告结果的混杂因素。确定的混杂因素包括不同的手术医生、不同的手术方案和不同的修正手术率。
总体而言,本次系统回顾得出了两个重要结论。首先,文献中对于 PSO 器械对长期患者结局的长期影响尚无共识。其次,该领域的研究受到影响报告结果适用性的混杂因素的限制。