Objectives: To examine the literature and synthesize the available reports for the best possible option between absorbable, nonabsorbable, and tissue adhesives in cleft lip skin closure. Design: We conducted systematic searches for randomized controlled trials and controlled clinical trials in PubMed, Cochrane, Ovid Medline, and OpenGrey databases. Identified studies were retrieved and assessed for eligibility. All statistical analyses were done with Revman, version 5.4. Interventions: The intervention considered in this systematic review were techniques of cleft lip repair using resorbable sutures, nonabsorbable sutures, medical adhesives, or any combination of these. Outcome Measures: The primary outcomes assessed in the trials had to include any combination of the following: wound healing cosmesis and wound healing complications. While secondary outcomes considered were quality of life, direct and indirect costs to patients and health services, and participant satisfaction. Results: Only 6 studies met all inclusion criteria and were selected for qualitative analysis. A more favorable wound healing cosmesis was seen when nonabsorbable suture was used in cleft lip repair compared to absorbable sutures and tissue adhesives (CI, 0.65-4.35). This advantage was overshadowed by the significantly higher prevalence of postoperative complications when nonabsorbable sutures are used. Conclusion: Although the results point to more favorable cosmesis with nonabsorbable sutures and an overall more favorable outcome with either absorbable sutures or tissue adhesives, the 6 selected studies were assessed at an unclear risk of bias; therefore, the results of this study should be interpreted with caution and regarded as low-certainty evidence.

No abstract

No abstract

Objectives: To identify the various otological challenges associated with non-syndromic orofacial clefts, how these problems affect quality of life of patients with orofacial clefts and find out the perspectives and current trends in the management of otological problems. Design: We conducted systematic searches for retrospective studies, cross-sectional studies, case-control studies, cohorts’ longitudinal studies and prospective controlled trials in Medline and Google scholar databases. Identified studies were retrieved and assessed for eligibility. Results: Thirty-five articles met all inclusion criteria and were selected for qualitative analysis. Twenty-one articles evaluated otological challenges associated with cleft lip and palate, 7 articles evaluated associated quality of life of patients with otological challenges and 9 articles evaluated management of otological challenges. Based on the results from this review, otological challenges including otitis media with effusion, conductive and sensorineural hearing loss are commonly associated with cleft. The result is a reduced quality of life due to their negative effects on intelligibility and eloquence of speech. They can however be managed by various palatoplasty procedures, rapid maxillary expansion, and use of various otological aids performed at an early age. Conclusion: The prevalence otological challenges in the cleft population are high and these issues require early management due to their possible effects on quality of life. Hence, there is need to incorporate ear care in the routine management of cleft lip and palate.

Objectives: To answer the question, “how effective are nonsurgical treatment modalities compared to any form of surgical intervention (with or without adjunct treatments) in the management of oropharyngeal carcinoma (OPC)?” Data Sources: We conducted systematic searches for Randomized Controlled Trials and Controlled Clinical Trials in PubMed, Cochrane, Ovid Medline, and OpenGrey databases. The US National Institutes of Health Ongoing Trials Register and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing and past studies. Identified studies were retrieved and assessed for relevance. Review Methods: The primary outcomes assessed in the trials had to include any combination of overall survival, disease-free survival, locoregional control, and recurrence. While secondary outcomes considered were complications of treatment, participants’ satisfaction, costs to participants and health services, and quality of life. Results: Only 5 studies met all inclusion criteria and were selected for qualitative analysis. One compared radiotherapy with surgery, 2 compared chemoradiotherapy with surgery, and 2 compared chemoradiotherapy with transoral robotic surgery. Conclusion: Based on results from this review, surgery is the mainstay of OPC management. However, concurrent chemoradiotherapy is a viable alternative in patients with unresectable disease or disease difficult to access due to location, patients with advanced disease intolerant of surgery, and in patients who do not consent to surgery.