Oronasal Fistula Incidence Associated With Vomer Flap Repair of Cleft Palate: A Systematic Review and Meta-Analysis

Vandenberg, Katherine; Castle, Michael; Qeadan, Fares; Kraai, Tania

doi:10.1177/1055665620974562

Cited by 10 publications

(15 citation statements)

References 25 publications

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“…It was observed that only three studies performed before 2010 could qualify during the two-stage scrutiny [ 72 , 112 , 113 ]. Among the journals, the highest number of papers (n = 30) was published in the Cleft Palate Craniofacial Journal (CPCJ) [ 21 , 35 , 46 , 47 , 48 , 49 , 63 , 65 , 66 , 76 , 86 , 92 , 94 , 100 , 101 , 115 , 116 , 121 , 123 , 125 , 128 , 137 , 140 , 142 , 146 , 150 , 152 , 155 , 161 , 162 ] followed by The Cochrane Library (n = 8) [ 9 , 16 , 68 , 88 , 92 , 93 , 100 , 106 ] and the International Journal of Oral and Maxillofacial Surgery (n = 7) [ 31 , 72 , 89 , 93 , 106 , 110 , 135 ]. There was diversity among the journals of different specialties that had published the SRs related to CLP ( Supplementary Material S4 ).…”

Section: Resultsmentioning

confidence: 99%

“…The study characteristics under this domain and their further categorization under various subdomains are detailed in Supplementary Material S4 . Among 15 SRs [ 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 ], only 7 [ 135 , 136 , 141 , 142 , 143 , 144 , 145 ] had their protocol registered prior to conducting the study ( Figure 4 ). Meta-analysis was performed in 6 of the studies [ 133 , 140 , 142 , 143 , 144 , 145 ] ( Supplementary Material S4 ).…”

Section: Resultsmentioning

confidence: 99%

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Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

Srivastav,

Tewari,

Antonarakis

et al. 2023

JCM

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Background: Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. Objectives: To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. Search Methods: The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. Selection criteria: Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. Data collection and analysis: A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. Results: A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. Conclusions: The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. Registration: A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

Srivastav,

Tewari,

Antonarakis

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Three (23.08%) patients with intraoral wounds and a palatal bone loss of about 7–8 mm developed an oronasal fistula with passage of water and food in the nasal cavity. These were closed within 15–20 days after primary surgery by a palatal mucoperiosteal flap [ 20 ]. All three healed without further incidents.…”

Section: Resultsmentioning

confidence: 99%

Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries—A Novel Operation Method with the External Face Fixator

Deininger

Hofmann

Necchi³

et al. 2022

JCM

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Introduction: Craniomaxillofacial fractures (CMF) are common in low-income countries (LIC). Due to limited resources, treatment of these fractures usually consists of interdental wiring or immobilization with a Barton bandage to maintain the reduction by permanent occlusion. These non-surgical treatment methods often lead to unsatisfactory results, such as a disturbed dental occlusion and lockjaw. The aim of this study is to present an off-label treatment option for CMF by applying a hand fixator as external face fixator (EFF) and to demonstrate the surgical method in detail. Materials and Methods: The feasibility and postoperative outcomes of this new off-label operation technique were evaluated by analyzing patients with CMF (n = 13) treated at an NGO hospital in Sierra Leone between 2015 and 2019. Results: The application of the EFF was feasible. The biggest advantage compared to the conventional non-operative methods was, that a dynamic occlusion was still possible during the 6 weeks healing period. Hence, patients could eat and drink almost normally and perform dental hygiene with the EFF in place. We did not discover pintrack infections or other complications. Three patients developed an oronasal fistula due to traumatic a palatal bone loss of about 7–8 mm which was treated by a palatal mucoperiosteal flap 15–20 days after the first operation. Discussion and Conclusions: In LIC, where plate osteosynthesis for CMF cannot be performed due to limited resources the application of an EFF is a promising alternative for a better outcome and an improved quality of life for the patients.

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“…1,10,11 Still, anatomical descriptions are also frequently used in scientific literature. 12,13 The Pakistan Comprehensive Classification System however has not been cited yet to our knowledge in scientific literature besides the manuscript of the original author. 9 Sitzman et al published a study in 2018 that showed very limited inter-rater agreement for eight surgeons using the Pittsburgh classification system.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unraveling a Major Burden of Orofacial Clefts Analyses: Classification of Cleft Palate Fistulas by Cleft Surgeons

Houkes

Smit

Lachkar

et al. 2023

The Cleft Palate Craniofacial Journal

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Objective The objective of this study was to investigate how cleft surgeons classify palatal fistulas. We focused on three different anatomical locations (ie, hard palate, soft palate, junction hard/soft palate) to analyze agreement/disagreement at various anatomical locations. Design Cross-sectional survey study. Participants Participants in an international webinar that focused on palatal fistula treatment were included. Intervention Participants were presented with a survey pre- and post-webinar. Main outcomes Frequency of used classification systems for classifying oronasal fistulas and the inter-rater reliability of the Pittsburgh classification system. Results A total of 141 participants completed the questionnaires prior to the webinar and 109 participants completed the survey after the webinar. In total, four classification systems were used (ie, Pittsburgh, Pakistan Comprehensive Fistula Classification [PCFC], anatomical and ‘other’). The Pittsburgh classification was the most commonly used system in all cases. However, Pittsburgh inter-rater reliability was low (κ = 0.136 pre-webinar, and κ = 0.174 post-webinar). Surprisingly, a substantial shift was observed from the anatomical to Pittsburgh classification after the webinar, indicating increased awareness of the usability of the Pittsburgh classification system. Conclusions This study demonstrates a large heterogeneity with regards to the classification of cleft palate fistulas. Interestingly, a shift was observed from the anatomical to Pittsburgh classification after the webinar. However, the inter-rater reliability for using the Pittsburgh classification was low. Classifying palatal fistulas in a homogenous fashion could enhance comparison of primary palate repair and could improve treatment of palatal fistulas.

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Oronasal Fistula Incidence Associated With Vomer Flap Repair of Cleft Palate: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 25 publications

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries—A Novel Operation Method with the External Face Fixator

Unraveling a Major Burden of Orofacial Clefts Analyses: Classification of Cleft Palate Fistulas by Cleft Surgeons

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