Naidu Priyanka, Yao Caroline A, Chong David K, Magee William P
Operation Smile Incorporated, Virginia Beach, Va.
Department of Plastic and Reconstructive Surgery, Children's Hospital Los Angeles, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2022 Mar 28;10(3):e4019. doi: 10.1097/GOX.0000000000004019. eCollection 2022 Mar.
Orofacial clefting is a common reconstructive surgical condition that often involves the palate. Cleft palate repair has evolved over three centuries from merely achieving anatomical closure to prioritizing speech development and avoiding midface hypoplasia. Despite centuries of advancements, there is still substantial controversy and variable consensus on technique, timing, and sequence of cleft palate repair procedures. Furthermore, evaluating the success of various techniques is hindered by a lack of universal outcome metrics and difficulty maintaining long-term follow-up. This article presents the current controversies of cleft palate repair and details how the history of cleft palate repair has influenced current techniques commonly used worldwide. Our review highlights the need for a global consortium on cleft care to gather expert opinions on current practices and outcomes and to standardize technique classifications. An understanding of global protocols is crucial in an attempt to standardize technique and timing to achieve anatomical closure with optimal velopharyngeal competence, while also minimizing the occurrence of maxillary hypoplasia and palatal fistulae.
口腔颌面裂是一种常见的需要进行重建手术的病症，常累及腭部。腭裂修复术在三个多世纪里不断发展，从仅仅实现解剖学上的闭合，到将语音发育作为优先考量并避免面中部发育不全。尽管历经数百年的进步，但在腭裂修复手术的技术、时机和顺序方面，仍存在大量争议且共识不一。此外，由于缺乏通用的结果指标以及难以维持长期随访，对各种技术的成功评估受到了阻碍。本文阐述了腭裂修复术当前存在的争议，并详细介绍了腭裂修复术的历史如何影响了目前全球普遍使用的技术。我们的综述强调，需要成立一个全球腭裂治疗联盟，以收集有关当前实践和结果的专家意见，并规范技术分类。了解全球方案对于标准化技术和时机至关重要，这样既能实现解剖学闭合并具备最佳的腭咽功能，又能尽量减少上颌骨发育不全和腭瘘的发生。
