Long term outcome of presurgical infant orthopaedics in patients with cleft lip and palate: A systematic review and meta-analysis

Abstract

To evaluate the long term outcome of Presurgical Infant Orthopaedics (PSIO) in patients with Cleft Lip and Palate (CLP). A systematic literature search was performed according to PRISMA guidelines of articles from Jan 2011 till Feb 2021, using PubMed, Cochrane database and manual searching in the institutional library. Fifteen articles which met the inclusion and exclusion criteria were ranked according to the Oxford Centre for Evidence based Medicine – Levels of Evidence. The quality assessment of selected systematic reviews was done with ROBIS tool. Studies included for meta-analysis were analyzed with Q statistic methods, I index, fixed-effects, DerSimonian-Laird Random effects and Begg-Mazumdar bias indicator. Selected fifteen articles were qualitatively assessed for various parameters on long term outcome of PSIO (minimum of 5 years), showed a positive outcome in nasolabial and pharyngeal airway parameters. Due to heterogeneity in the studies, meta-analysis was carried out for five studies in which nasolabial aesthetics parameters showed a significant improvement in PSIO group compared to control group (Q Statistic : 569.52523, P-value<0.001). The PSIO in patients with CLP shows significant positive changes in nasolabial aesthetics and pharyngeal airway on a long term. These results should be considered with caution as the heterogeneity of included studies cannot be denied. Hence, more controlled and well conducted studies should be performed, focussing on the individual parameters for long term outcome of PSIO.