scholarly journals Maxillary Growth and Speech Outcome in Patient with Cleft Lip and Palate after Two-Stage Palate Repair: A Systematic Review

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Mulyadi Mulyadi ◽  
Prasetyanugraheni Kreshanti ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Literature Search ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Two Stage ◽  
Language Studies ◽  
Palate Repair ◽  
Maxillary Growth

Background: The management of patients with cleft lip and palate is complex, where the treatment outcome is judged on the balance between aesthetics, speech, and maxillary growth. Up to now, there is no generally accepted treatment protocol. Every center must find the best-suited protocol treatment for their population. Methods: A systematic review through literature search was conducted for English-language studies in PubMed. This search was conducted in September 2011 using EndNote X3 with keywords: Two-stage Palate Repair and Maxillary Growth and Two-stage Palate Repair and Speech Outcome. Both retrospective and prospective studies on maxillary growth and speech outcome in patient with cleft lip and palate after two-stage palate repair published from 2001 to 2012 were included. Result: From the reviewed of 37 articles, only 14 articles fit the inclusions criteria, three articles discussed the outcome of maxillary growth and speech outcome, eight articles only discussed the maxillary growth and the rest of articles only discussed the speech outcome. Conclusion:From this review we found that most of the two-stage palate repair results in better maxillary growth, but only few of them results in good speech outcome. We will perform further study based on this review to discover a new protocol for the management of palate repair in our center.

Two-Stage Palate Repair with Delayed Hard Palate Closure Is Related to Favorable Maxillary Growth in Unilateral Cleft Lip and Palate

2010 ◽  
Vol 125 (5) ◽  
pp. 1503-1510 ◽  
Author(s):  
Yu-Fang Liao ◽  
I-Ying Yang ◽  
Ruby Wang ◽  
Claudia Yun ◽  
Chiung-Shing Huang
Keyword(s):  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Two Stage ◽  
Palate Repair ◽  
Maxillary Growth

Maxillary Growth Controversies after Two-Stage Palatal Repair with Delayed Hard Palate Closure in Unilateral Cleft Lip and Palate Patients: Perspectives from Literature and Personal Experience

2007 ◽  
Vol 44 (2) ◽  
pp. 129-136 ◽  
Author(s):  
Hans Friede
Keyword(s):  
Personal Experience ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Two Stage ◽  
Palate Repair ◽  
Maxillary Growth ◽  
Palatal Surgery

Objective: To analyze published papers dealing with delayed hard palate repair within a two-stage palatal surgery protocol in treatment of cleft lip and palate. Timing of the procedures, methods used, as well as growth results were considered. Method: By utilizing this information in relation to knowledge about normal maxillary development, efforts were made to explain differences in growth outcome between different investigations. Particularly, follow-up reports of unilateral cleft lip and palate patients with records up to at least 10 years of age were studied. Results: Most papers reported an excellent or very good maxillary growth outcome after their delayed hard palate closure protocols. Where unsatisfactory results were published, reasonable explanations were found accounting for why the method had failed the expectation of good maxillary growth. Conclusion: Based on the published reports and the experience from a cleft team where the studied protocol has been practiced since 1975, recommendation for method as well as timing for the two-stage protocol is laid out in some detail.

Hard Palate Repair Timing and Facial Growth in Cleft Lip and Palate: A Systematic Review

2006 ◽  
Vol 43 (5) ◽  
pp. 563-570 ◽  
Author(s):  
Yu-Fang Liao ◽  
Michael Mars
Keyword(s):  
Systematic Review ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Case Reports ◽  
Case Series ◽  
Long Term Results ◽  
Facial Growth ◽  
Cleft Lip Palate ◽  
Palate Repair

Objective: To evaluate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate, with special reference to cranial base, maxilla, mandible, jaw relation, and incisor relation. Design: A systematic review. Methods: The search strategy was based on the key words “facial growth,” “cleft lip palate,” and “timing of (hard) palate repair.” Case reports, case-series, and studies with no control or comparison group in the sample were excluded. Results: Fifteen studies met the selection criteria. All the studies were retrospective and nonrandomized. Five studies used cephalometry and casts, seven used cephalometry, and three used casts. Methodological deficiencies and heterogeneity of the studies prevented major conclusions. Conclusion: The review highlights the importance of further research. Prospective well-designed, controlled studies, especially targeting long-term results, are required to elucidate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate.

Early Two-Stage Palatoplasty Using Modified Furlow's Veloplasty

2010 ◽  
Vol 47 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Nishio Juntaro ◽  
Yamanishi Tadashi ◽  
Hiroshi Kohara ◽  
Yoshiko Hirano ◽  
Michiyo Sako ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Dental Occlusion ◽  
Central Incisor ◽  
Two Stage ◽  
Treatment Protocols ◽  
Normal Occlusion ◽  
New Treatment ◽  
Velopharyngeal Function

Objective To achieve sufficient velopharyngeal function and maxillary growth for patients with unilateral cleft lip and palate (UCLP), the authors have designed a new treatment protocol for palate closure involving early two-stage palatoplasty with modified Furlow veloplasty. Details of the surgical protocol and the outcomes of the dental occlusion of patients at 4 years of age are presented. Design and Setting This was an institutional retrospective study. Patients Seventy-two UCLP patients were divided into two groups based on their treatment protocols: patients treated using the early two-stage palatoplasty protocol (ETS group; n = 30) and patients treated using Wardill-Kilner push-back palatoplasty performed at 1 year of age (PB group; n = 42). Interventions The features of the ETS protocol are as follows: The soft palate is repaired at 12 months of age using a modified Furlow technique. The residual cleft in the hard palate is closed at 18 months of age. Lip repair is carried out at 3 months of age with a modified Millard technique for all subjects. Results The ETS group showed a significantly better occlusal condition than the PB group. The incidence of normal occlusion at the noncleft side central incisor was 7.1% in the PB group; whereas, it was 66.7% in the ETS group. Conclusion The results indicate that the early two-stage protocol is advantageous for UCLP children in attaining better dental occlusion at 4 years of age.

scholarly journals Maxillary Growth Evaluation After Cleft Palate Repair Using Goslon Criteria: Preliminary Study

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Huntal Simamora ◽  
Evie Lamtiur ◽  
Nur A. ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mean Value ◽  
Treatment Result ◽  
Maxillary Hypoplasia ◽  
Post Surgery ◽  
Cleft Lip Palate ◽  
Palate Repair ◽  
Maxillary Growth

Background: The goal of palatoplasty is to achieve normal maxillofacial growth, normal speech, and prevent hearing loss. Disturbance of maxillary growth may occur in cleft lip palate patients after palatoplasty. To determine how many patients later developed a disrupted maxillary growth following operations, a retrospective study was designed to evaluate patients with complete unilateral cleft lip and palate who have undergone two-flap palatoplasty.Methods:A retrospective analytic study evaluated the maxillary growth of 15 consecutive unilateral cleft lip and palate patient aged around 8-year-old treated in the Division of Plastic Surgery Cipto Mangunkusumo Hospital, Jakarta. Cephalogram and dental study models were used to assess growth. Cleft lip and palate repair were performed to all patients without alveolar bone graft or any orthodontic treatment. Result: The cephalogram shows that 53,3% of the patients developed maxillary hypoplasia post palatoplasty. Mean value of the Goslon Yardstick was 3,53 (intermediate category by Goslon criteria).No patient fell into the Goslon 1 or 5 categories. Discussion: Disturbed maxillary growth is postulated to be caused by the manipulation and suturing of the maxillary vomer, and scarring of the dentoalveoli post-surgery. Another contributing factor is the intrinsic tissue deficiency. Conclusion: Maxillary hypoplasia is a possible complication following two !ap palatopasty, affecting either anteroposterior, transversal and vertical maxillary growth. This finding needs to be proven especially after the process of growth ceased. It is highly probable that maxillary disruption is higher when the two flap palatoplasty technique leaves lateral areas of denuded bone on the maxillary tuberosity.

Speech and Hearing Outcomes of the Patients with Cleft Lip and Palate: Comparison between One-Stage Simultaneous and Two-Stage Surgical Repairs

2020 ◽  
Vol 103 (11) ◽  
pp. 1171-1177
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Common Belief ◽  
Two Stage ◽  
Treatment Protocols ◽  
Palatal Fistula ◽  
One Stage ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Palate Repair

Background: Conventional treatment for cleft lip and palate patients is lip repair at three to four months and then palatal repair at nine to 12 months of age. However, for the patients who delay seeing a doctor especially in a developing area such as Northern Thailand, simultaneous lip and palate repair is performed at 12 to 18 months of age or later, depending on the age at the first visit. It is a common belief that patients with cleft lip and palate will be behind non-cleft patients in early development phonemes because of the open palate. This delay persists until the palate is repaired and on into the postoperative period. This proposition has not been proven with long-term clinical outcomes in one-stage repairs. Objective: To investigate the effects of one-stage repair on speech assessment, hearing, and incidence of palatal fistula. The results were compared with conventional two-stage surgical repairs. Materials and Methods: The present study was designed two groups. Group 1 consisted of 25 children (mean age 11.28±1.93 years) treated with a one-stage repair. Cleft lip, palate, and alveolus were repaired at a single surgical session in the first 18 months of life (mean age at the time of surgery 13.52±4.51 months). Group 2 consisted of 17 children (mean age 11.02±2.23 years) treated in two-stage surgical repairs. Lip repair was performed at a median age of 4.01 months (IQR 3.62 to 5.46), and palate repair was performed at a mean age of 13.54±4.14 months. Both groups underwent cleft lip and palate repairs at the Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University between January 1, 2004 and December 31, 2010. Speech and hearing for all patients were evaluated by experienced ENT doctors. The palatal fistula was evaluated by the same plastic surgeons. Results: One-stage repair showed significant normal articulation and less articulation disorder when compared with two-stage surgical repairs. However, no significant difference was determined for other speech assessments, hearing, and incidence of palatal fistula. Conclusion: Because one-stage repair seems to have a more positive influence on articulation, and both surgical treatment protocols give similar results on speech assessments, hearing, and incidence of palatal fistula, regardless of the timing of the surgery, the one-stage repair is not inferior to conventional two-stage surgical repairs for patients in developing areas. This is due to several important advantages, such as less hospitalization, lower cost, and less chance of nosocomial infection. Keywords: One-stage repair, Speech, Hearing, Palatal fistula, Cleft lip, Palate

WITHDRAWN—Administrative Duplicate Publication: Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-term Follow-up After 1- or 2-Stage Palate Repair

2018 ◽  
Vol 55 (5) ◽  
pp. 758-768 ◽  
Author(s):  
Staffan Morén ◽  
Per Åke Lindestad ◽  
Mats Holmström ◽  
Maria Mani
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Voice Quality ◽  
Two Stage ◽  
Duplicate Publication ◽  
Long Term Follow Up ◽  
Palate Repair

Morén, S., Lindestad, P. Å., Holmström, M., & Mani, M. (2018). Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-term Follow-up After 1- or 2-Stage Palate Repair. The Cleft Palate-Craniofacial Journal, 55(5), 758–768. DOI: 10.1177/1055665618754946 Article withdrawn by publisher. Due to an administrative error, this article was accidentally published in Volume 55 Issue 5 as well as Volume 55 Issue 8 of publishing year 2018 with different DOIs and different page numbers. The incorrect version of the article with DOI: 10.1177/1055665618754946 has been replaced with this correction notice. The correct and citable version of the article remains: Morén, S., Lindestad, P. Å., Holmström, M., & Mani, M. (2018). Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair. The Cleft Palate-Craniofacial Journal, 55(8), 1103–1114. DOI: 10.1177/1055665618764521

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