TY - JOUR
T1 - Speech correcting surgery after primary palatoplasty
T2 - a systematic literature review and meta-analysis
AU - Hofman, Lieke
AU - van Dongen, Joris A.
AU - van Rees, Rosalie C.M.
AU - Jenniskens, Kevin
AU - Haverkamp, Sarah J.
AU - Beentjes, Yente S.
AU - van der Molen, Aebele B.Mink
AU - Paes, Emma C.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2024/1
Y1 - 2024/1
N2 - Objectives: In cleft palate patients, the soft palate is commonly closed using straight-line palatoplasty, Z-palatoplasty, or palatoplasty with buccal flaps. Currently, it is unknown which surgical technique is superior regarding speech outcomes. The aim of this review is to study the incidence of speech correcting surgery (SCS) per soft palatoplasty technique and to identify variables which are associated with this outcome. Materials and methods: A systematic literature search was carried out according to the PRISMA guidelines. Inclusion and exclusion criteria were applied to focus on the incidence of SCS after soft palatoplasty. Additional variables like surgical modification, cleft morphology, syndrome, age at palatoplasty, fistula and assessment of velopharyngeal function were reported. A modified New-Ottawa Scale (NOS) was used for quality appraisal. Pooled estimates from the meta-analysis were calculated using a random-effects model. Results: One thousand twenty-nine studies were found of which 54 were included in the analysis. The pooled estimate proportion of SCS after straight-line palatoplasty was 19% (95% CI 15–24), after Z-palatoplasty 6% (95% CI 4–9), and after palatoplasty with buccal flaps 7% (95% CI 4–11). Conclusions: A lower SCS rate was found in patients receiving Z-palatoplasty when compared to straight-line palatoplasty. We propose a minimum set of outcome parameters which ideally should be included in future studies regarding speech outcomes after cleft palate repair. Clinical relevance: Current literature reports highly heterogenous data regarding cleft palate repair. Our recommended set of parameters may address this inconsistency and could make intercenter comparison possible and of better quality.
AB - Objectives: In cleft palate patients, the soft palate is commonly closed using straight-line palatoplasty, Z-palatoplasty, or palatoplasty with buccal flaps. Currently, it is unknown which surgical technique is superior regarding speech outcomes. The aim of this review is to study the incidence of speech correcting surgery (SCS) per soft palatoplasty technique and to identify variables which are associated with this outcome. Materials and methods: A systematic literature search was carried out according to the PRISMA guidelines. Inclusion and exclusion criteria were applied to focus on the incidence of SCS after soft palatoplasty. Additional variables like surgical modification, cleft morphology, syndrome, age at palatoplasty, fistula and assessment of velopharyngeal function were reported. A modified New-Ottawa Scale (NOS) was used for quality appraisal. Pooled estimates from the meta-analysis were calculated using a random-effects model. Results: One thousand twenty-nine studies were found of which 54 were included in the analysis. The pooled estimate proportion of SCS after straight-line palatoplasty was 19% (95% CI 15–24), after Z-palatoplasty 6% (95% CI 4–9), and after palatoplasty with buccal flaps 7% (95% CI 4–11). Conclusions: A lower SCS rate was found in patients receiving Z-palatoplasty when compared to straight-line palatoplasty. We propose a minimum set of outcome parameters which ideally should be included in future studies regarding speech outcomes after cleft palate repair. Clinical relevance: Current literature reports highly heterogenous data regarding cleft palate repair. Our recommended set of parameters may address this inconsistency and could make intercenter comparison possible and of better quality.
KW - Cleft palate
KW - Cleft palate repair
KW - Primary palatoplasty
KW - Speech correcting surgery
KW - Velopharyngeal insufficiency
UR - http://www.scopus.com/inward/record.url?scp=85180860390&partnerID=8YFLogxK
U2 - 10.1007/s00784-023-05391-7
DO - 10.1007/s00784-023-05391-7
M3 - Review article
C2 - 38157017
AN - SCOPUS:85180860390
SN - 1432-6981
VL - 28
JO - Clinical Oral Investigations
JF - Clinical Oral Investigations
IS - 1
M1 - 58
ER -