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The purpose of this research is to learn the outcomes of lip symmetry after cleft lip repair by Fisher in unilateral cleft lip compared with other techniques. This systematic review searched English full-text available articles in 4 databases: Cochrane, PubMed, ScienceDirect, and Google Scholar, and hand searched through grey literature and reference lists. Subjects were those with unilateral cleft lip without syndromic disorders who had primary cleft lip repair. The authors compared the technique by Fisher with other cleft lip repair techniques. Outcomes were lip symmetry determined quantitatively by lip anthropometric measurement and qualitatively by the Steffensen grading criteria. Four studies were included with a total of 150 cleft lip repairs, comparing the technique by Fisher with techniques by Millard, Mohler, and modified Millard. The 4 studies underwent critical appraisal, data analysis, qualitative synthesis, and meta-analysis. Assessment with Cochrane Risk of Bias 2 for randomized controlled trials and “Risk of Bias in Nonrandomized Studies–of Interventions” for nonrandomized studies displayed an overall high risk of bias in the included studies. “Grading of recommendations, assessment, development, and evaluation” revealed a very low quality of evidence for this review. All 4 studies noted better subjective lip symmetry in the technique by Fisher, but lip and vermilion height were better after the technique by Millard. This review found superior lip symmetry quality but inferior lip symmetry anthropometry after the technique by Fisher compared with the technique by Millard and its modifications, with a low quality of evidence.
The purpose of this research is to learn the outcomes of lip symmetry after cleft lip repair by Fisher in unilateral cleft lip compared with other techniques. This systematic review searched English full-text available articles in 4 databases: Cochrane, PubMed, ScienceDirect, and Google Scholar, and hand searched through grey literature and reference lists. Subjects were those with unilateral cleft lip without syndromic disorders who had primary cleft lip repair. The authors compared the technique by Fisher with other cleft lip repair techniques. Outcomes were lip symmetry determined quantitatively by lip anthropometric measurement and qualitatively by the Steffensen grading criteria. Four studies were included with a total of 150 cleft lip repairs, comparing the technique by Fisher with techniques by Millard, Mohler, and modified Millard. The 4 studies underwent critical appraisal, data analysis, qualitative synthesis, and meta-analysis. Assessment with Cochrane Risk of Bias 2 for randomized controlled trials and “Risk of Bias in Nonrandomized Studies–of Interventions” for nonrandomized studies displayed an overall high risk of bias in the included studies. “Grading of recommendations, assessment, development, and evaluation” revealed a very low quality of evidence for this review. All 4 studies noted better subjective lip symmetry in the technique by Fisher, but lip and vermilion height were better after the technique by Millard. This review found superior lip symmetry quality but inferior lip symmetry anthropometry after the technique by Fisher compared with the technique by Millard and its modifications, with a low quality of evidence.
Objective This study aims to evaluate the impact of COVID-19 and the current situation for cleft lip/palate treatment surgeries within Brazil's public health system. Design Our retrospective study analyzed CL/P corrective surgeries in Brazil's health system using DATASUS TabNet data from March 2020 to December 2022, with historical data from January 2016 to February 2020. We employed ARIMA analysis to estimate pandemic-related surgery cancellations. Results In 2020, 1992 (CI 95%: 989–2995) CL/P surgeries were not conducted due to pandemics, a 44.1% (CI 95%: 28.1–54.2%) decrease compared to expectations for march to December 2020. Between the onset of the pandemic in Brazil and the end of 2022, 10,643 surgeries were performed in the country, representing a 33.8% shortfall compared to the expected number for the period (16,076; 95% CI: 9697–22,456). Conclusion The study highlights COVID-19's impact on CL/P surgeries in Brazil. Post-pandemic, surgeries increased but regional disparities remain, urging collaborative efforts to improve services and support affected patients.
Objectives to assess the levels of anxiety, depression, stress and fear of COVID-19 in non-syndromic cleft lip and/or palate (NSCL/P) children parents and caregivers. Materials and Methods Cross-sectional case-control study conducted at a Craniofacial Anomalies Rehabilitation Center, Brazil. Non-probabilistic convenience sampling was used and data were collected between October 2021 and November 2022. Variables were assessed by Depression, Anxiety and Stress Scale (DASS-21) and Fear of COVID-19 Scale (FC-19S). Pearson's chi-square test and multivariate binary logistic regression model have been performed. Results Data were obtained of 80 NSCL/P parents group and 130 by control group. Severe symptoms were higher in NSCL/P parents indicated by rates (8.8% vs 69% to anxiety; 12.5% vs 8.5% to depression and 17.5% vs 10.0% to stress). As for the predilection in case group there was an association (p < 0.05) for manifestation of mild stress (OR: 4.09; 95%CI 1.28–13.06). Control group caregivers were more fear of COVID-19 (43.8% vs 28.7% p < 0.05). Conclusion There were no significant differences in anxiety, depression, and stress levels between groups. NSCL/P children parents and caregivers were less fear of COVID-19. There is a predilection for severe symptoms in the case group. Clinical Relevance: This is the first cross-sectional study analyzing fear of COVID-19 in NSCL/P children parents and caregivers. These people should receive greater attention by multiprofessional team due to the predisposition of illness in mental health.
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