Mink van der Molen Aebele B, van Breugel Johanna M M, Janssen Nard G, Admiraal Ronald J C, van Adrichem Leon N A, Bierenbroodspot Frank, Bittermann Dirk, van den Boogaard Marie-José H, Broos Pieter H, Dijkstra-Putkamer Janet J M, van Gemert-Schriks Martine C M, Kortlever Andrea L J, Mouës-Vink Chantal M, Swanenburg de Veye Henriette F N, van Tol-Verbeek Nanouk, Vermeij-Keers Christl, de Wilde Hester, Kuijpers-Jagtman Anne Marie
Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Department Maxillo Facial Surgery and Dentistry, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
J Clin Med. 2021 Oct 20;10(21):4813. doi: 10.3390/jcm10214813.
Significant treatment variation exists in the Netherlands between teams treating patients with cleft lip, alveolus, and/or palate, resulting in a confusing and undesirable situation for patients, parents, and practitioners. Therefore, to optimize cleft care, clinical practice guidelines (CPGs) were developed. The aim of this report is to describe CPG development, share the main recommendations, and indicate knowledge gaps regarding cleft care. Together with patients and parents, a multidisciplinary working group of representatives from all relevant disciplines assisted by two experienced epidemiologists identified the topics to be addressed in the CPGs. Searching the Medline, Embase, and Cochrane Library databases identified 5157 articles, 60 of which remained after applying inclusion and exclusion criteria. We rated the quality of the evidence from moderate to very low. The working group formulated 71 recommendations regarding genetic testing, feeding, lip and palate closure, hearing, hypernasality, bone grafting, orthodontics, psychosocial guidance, dentistry, osteotomy versus distraction, and rhinoplasty. The final CPGs were obtained after review by all stakeholders and allow cleft teams to base their treatment on current knowledge. With high-quality evidence lacking, the need for additional high-quality studies has become apparent.
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