Post-operative outcomes after cleft palate repair in syndromic and non-syndromic children: a systematic review protocol

Abstract

BackgroundThere is a lack of high-level evidence on the surgical management of cleft palate. An appreciation of the differences in the complication rates between different surgical techniques and timing of repair is essential in optimizing cleft palate management.MethodA comprehensive electronic database search will be conducted on the complication rates associated with cleft palate repair using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Two independent reviewers with expertise in cleft pathology will screen all appropriate titles, abstracts, and full-text publications prior to deciding whether each meet the predetermined inclusion criteria. The study findings will be tabulated and summarized. The primary outcomes will be the rate of palatal fistula, the incidence and severity of velopharyngeal insufficiency, and the rate of maxillary hypoplasia with different techniques and also the timing of the repair. A meta-analysis will be conducted using a random effects model.DiscussionThe evidence behind the optimal surgical approach to cleft palate repair is minimal, with no gold standard technique identified to date for a certain type of cleft palate. It is essential to appreciate how the complication rates differ between each surgical technique and each time point of repair, in order to optimize the management of these patients. A more critical evaluation of the outcomes of different cleft palate repair methods may also provide insight into more effective surgical approaches for different types of cleft palates.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0438-2) contains supplementary material, which is available to authorized users.

Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair

“…They did not focus on monitoring the rate of breastfeeding, but pointed out those alternative methods of feeding were beneficial (Duarte et al, 2016). Other studies focused on the growth outcome and the frequency of postoperative complications and did not determine mode of nutrition (Bessell et al, 2011; Zhang et al, 2017). Our data from one cohort of infants delivering in BFHI hospital showed a high breastfeeding rate in the CL group (78%; Burianova et al, 2017).…”

Biomaterials for Cleft Lip and Palate Regeneration

“…The management of patients with CL/P pathology is complex and requires a multidisciplinary approach that includes plastic surgeons, maxillofacial surgeons (cleft surgeons), otolaryngologists, speech/language pathologists, audiologists, dentists, orthodontists, psychologists, geneticists, and social workers. Different tissues including bone, dental organs, and soft tissue from the respiratory system are largely affected during the CL/P reconstruction (Figure 3), therefore it is necessary to standardize the perioperative management of these patients [17].…”

“…It was described that due to a sevoflurane-induced gene deletion, an incomplete development of the palate and alveolus was achieved. However, in many cases, the gene defect led to other pathologies and perinatal lethality, therefore, this methodology has been considered as not suitable to evaluate new bone grafts [17,24].…”

“…Contrary to these findings, Korn et al showed that when using hydroxyapatite/collagen composite scaffolds, the ossification of the defect was not enhanced, probably due to the micromovements of the remaining non-resorbable HA particles after their degradation of the collagen that hampered, as in the case of autografts, the ossification of the defects. Nevertheless, most of the investigations using scaffolds based on bioceramics are supported by cell therapy and growth factors and although the osteoinduction mechanism has not yet been completely revealed, the relationship between the physical and chemical features of the osteoinductive bioceramic and the osteogenic differentiation of HMSCs and their suitability for craniofacial defect repair including alveolar cleft palate regeneration has been demonstrated [8,17,19,21,25].…”

Aboard the Smile Train: Outcomes of Primary Cleft Palate Repair at a Tertiary Care Center: À bord du Smile Train : les résultats cliniques de réparations de fentes palatines dans un centre de soins tertiaires

“…Despite efforts to standardize management, there is considerable variation in cleft treatment across centers, with no ubiquitous, gold standard approach to care. 6 All procedures, however, are geared toward addressing the functional and anatomic deformity of the cleft. 5,6…”