Chinta Sachin R, Segrera Sergio, Friedman Rebecca, Shah Alay R, Kantar Rami S, Volk Angela S, Staffenberg David, Rodriguez Eduardo D
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY 10016, USA.
J Clin Med. 2024 Sep 25;13(19):5703. doi: 10.3390/jcm13195703.
This study aims to determine a generalized outcome and risk profile for patients undergoing orthognathic surgery for the definitive treatment of cleft lip and palate. Furthermore, we hope to determine the key risk factors that cause increased risk for cleft lip and palate patients undergoing orthognathic surgery. This study includes a systematic review using PubMed, MEDLINE, Cochrane, and Scopus. Data curation utilized Covidence software, with dual-reviewer screening and conflict resolution by a third party, focusing on publications with the full texts available. The initial search yielded 1697 articles. Following title, abstract, and full-text screening, a total of 62 articles were included in this review. A total of 70.9% of included articles had moderate bias, with the rest having low risk of bias. The sample consisted of 2550 patients with an average age of about 20 years and an average follow-up of 16.8 months. The most employed procedure was Le Fort I osteotomy (99%). In terms of velopharyngeal function, there were notable increases in insufficiency and severity scores, with an average 63% worsening score from the baseline. That being said, patients experienced an average 33% improvement in speech articulation. Furthermore, the average horizontal movement was reported to be 6.09 mm with a subsequent relapse of 0.98 mm overall. This systematic review distills data from 62 articles and 2550 patients. It highlights the efficacy of orthognathic surgery in addressing oropharyngeal and aesthetic deficits. This study identifies relapse and velopharyngeal insufficiency as recurrent complications. These insights inform surgical refinement and patient counseling, laying a foundation for enhanced clinical protocols.
本研究旨在确定接受正颌手术以最终治疗唇腭裂患者的一般化结局和风险概况。此外，我们希望确定导致唇腭裂患者接受正颌手术风险增加的关键风险因素。本研究包括使用PubMed、MEDLINE、Cochrane和Scopus进行的系统评价。数据管理使用Covidence软件，由两名审阅者进行筛选，并由第三方解决冲突，重点关注可获取全文的出版物。初步检索产生了1697篇文章。经过标题、摘要和全文筛选，本综述共纳入62篇文章。纳入的文章中共有70.9%存在中度偏倚，其余文章的偏倚风险较低。样本包括2550例患者，平均年龄约20岁，平均随访16.8个月。最常用的手术是Le Fort I截骨术（99%）。在腭咽功能方面，功能不全和严重程度评分显著增加，与基线相比平均恶化评分63%。话虽如此，患者的语音清晰度平均提高了33%。此外，据报道平均水平移动为6.09 mm，随后总体复发0.98 mm。本系统评价提炼了62篇文章和2550例患者的数据。它突出了正颌手术在解决口咽和美学缺陷方面的疗效。本研究确定复发和腭咽功能不全是反复出现的并发症。这些见解为手术改进和患者咨询提供了依据，为加强临床方案奠定了基础。
