Evaluation of Palatoplasty techniques in cleft patients: An integrative review
DOI:
https://doi.org/10.33448/rsd-v12i11.43668Keywords:
Cleft palate; Maxillofacial development; Sugery, oral.Abstract
Cleft palate is a multifactorial defect that occurs in intrauterine life, because there is no complete fusion of the maxillary processes. Thus, palatoplasty aims to repair the cleft and has techniques that improve the patient's quality of life. Objective: To evaluate the techniques used in palatoplasty surgery, highlighting the one with the best results in terms of management and postoperative period. Methodology: Integrative literature review study, searching Scielo and Pubmed databases from January to october 2023. The selected articles had a time frame from 2004 to 2021, and of the 545 articles found, 25 were used. Results: The authors reported the prevalence of clefts and their classification. In addition, regarding the techniques, they addressed similar results in postoperative success rates and management, in addition, they came to the conclusion that there are techniques that increase the incidence of fistula and nasalance. Discussion: There was debate among the authors regarding the predilection of cleft palates. There was disagreement regarding the preference for one-stage and two-stage surgery. Furlow's and Bardach's techniques showed similar results and showed better success rates. Conclusion: Therefore, it is concluded that the choice of surgical technique regarding management is the choice of the professional. On the other hand, in terms of treatment effectiveness, the Furlow and Bardach techniques proved to be more effective.
References
Afrooz, P. N., MacIsaac, Z., Rottgers, S. A., Ford, M., Grunwaldt, L. J., & Kumar, A. R. (2015). A comparison of speech outcomes using radical intravelar veloplasty or furlow palatoplasty for the treatment of velopharyngeal insufficiency associated with occult submucous cleft palate. Annals of plastic surgery, 74(2), 182–186. https://doi.org/10.1097/SAP.0b013e3182956632
Álvarez Carvajal, D. C., Inostroza-Allende, F., Geldres Meneses, M. B., & Giugliano Villarroel, C. (2023). Speech Outcomes and Velopharyngeal Function in Children Undergoing Submucous Cleft Palate Repair. The Journal of craniofacial surgery, 34(6), 1766–1771. https://doi.org/10.1097/SCS.0000000000009570
Calis, Mert et al (2018). Comparison of the speech results after correction of submucous cleft palate with furlow palatoplasty and pharyngeal flap combined with intravelar veloplasty. Journal of Craniofacial Surgery, v. 29, n. 1, p. e100-e103.
Dixon, M. J., Marazita, M. L., Beaty, T. H., & Murray, J. C. (2011). Cleft lip and palate: understanding genetic and environmental influences. Nature reviews. Genetics, 12(3), 167–178. https://doi.org/10.1038/nrg2933
Dong, Y., Dong, F., Zhang, X., Hao, F., Shi, P., Ren, G., Yong, P., & Guo, Y. (2012). An effect comparison between Furlow double opposing Z-plasty and two-flap palatoplasty on velopharyngeal closure. International journal of oral and maxillofacial surgery, 41(5), 604–611. https://doi.org/10.1016/j.ijom.2012.01.010
Freitas e Silva, D. S., Mauro, L. D., Oliveira, L. B., Ardenghi, T. M., & Bönecker, M. (2008). Estudo descritivo de fissuras lábio-palatinas relacionadas a fatores individuais, sistêmicos e sociais. RGO (Porto Alegre). 2008; 56:387-91.
Freitas, J. A. de S., Dalben, G. da S., Santamaria Júnior, M., & Freitas, P. Z. (2004). Current data on the characterization of oral clefts in Brazil. Brazilian Oral Research, 18(2), 128–133. https://doi.org/10.1590/S1806-83242004000200007
Frederick, R., Hogan, A. C., Seabolt, N., & Stocks, R. M. S. (2022). An Ideal Multidisciplinary Cleft Lip and Cleft Palate Care Team. Oral diseases, 28(5), 1412–1417. https://doi.org/10.1111/odi.14213
Horswell, B. B., & Chou, J. (2020). Does the Children's Hospital of Philadelphia Modification Improve the Fistula Rate in Furlow Double-Opposing Z-Plasty? Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 78(11), 2043–2053. https://doi.org/10.1016/j.joms.2019.08.018.
Jacob, M. F., Prearo, G. A., Brosco, T. V. de S., Silva, H. L. de A., & Dutka, J. de C. R. (2020). Fístula após palatoplastia primária: consenso entre profissionais da cirurgia plástica e da fonoaudiologia. Revista Brasileira De Cirurgia Plástica, 35(2), 142–148. https://doi.org/10.5935/2177-1235.2020RBCP0025
Jodeh, D. S., Nguyen, A. T. H., & Rottgers, S. A. (2019). Outcomes of Primary Palatoplasty: An Analysis Using the Pediatric Health Information System Database. Plastic and reconstructive surgery, 143(2), 533–539. https://doi.org/10.1097/PRS.0000000000005210
Kara, M., Calis, M., Kara, I., Kulak Kayikci, M. E., Gunaydin, R. O., & Ozgur, F. (2021). Comparison of speech outcomes using type 2b intravelar veloplasty or furlow double-opposing Z plasty for soft palate repair of patients with unilateral cleft lip and palate. Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery, 49(3), 215–222. https://doi.org/10.1016/j.jcms.2021.01.003
Katzel, E. B., Basile, P., Koltz, P. F., Marcus, J. R., & Girotto, J. A. (2009). Current surgical practices in cleft care: cleft palate repair techniques and postoperative care. Plastic and reconstructive surgery, 124(3), 899–906. https://doi.org/10.1097/PRS.0b013e3181b03824
Lorenzzoni, D., Carcereri, D. L., & Locks, A.. (2010). The importance of multi-professional, interdisciplinary care in rehabilitation and health promotion directed at patients with cleft lip/palate. Revista Odonto Ciência, 25(2), 198–203. https://doi.org/10.1590/S1980-65232010000200018
Martelli, D. R. B., Machado, R. A., Swerts, M. S. O., Rodrigues, L. A. M., Aquino, S. N. de, & Martelli Júnior, H. (2012). Fissuras lábio palatinas não sindrômicas: relação entre o sexo e a extensão clínica. Brazilian Journal of Otorhinolaryngology, 78(5), 116–120. https://doi.org/10.5935/1808-8694.20120018
Naros, A., Bartel, S., Bacher, M., Koos, B., Blumenstock, G., Wiechers, C., Poets, C. F., Reinert, S., & Krimmel, M. (2022). Speech Development in Cleft Palate with and without Robin Sequence. Plastic and reconstructive surgery, 149(2), 443–452. https://doi.org/10.1097/PRS.0000000000008730
Pereira, R. M. R., Melo, E. M. C., Coutinho, S. B., Vale, D. M. do, Siqueira, N., & Alonso, N.. (2011). Avaliação do crescimento craniofacial em portadores de fissuras labiopalatinas submetidos a palatoplastia em tempo único. Revista Brasileira De Cirurgia Plástica, 26(4), 624–630. https://doi.org/10.1590/S1983-51752011000400015
Rebouças, P. D.; Moreira, M. M.; Chagas, M. L. B. e Cunha Filho, J. F. (2014). Prevalência de fissuras labiopalatinas em um hospital de referência do nordeste do Brasil. Rev. Bras. Odontol. [online]. 1(1), 39-41.
Reddy, R. R., Gosla Reddy, S., Chilakalapudi, A., Kokali, S., Bronkhorst, E. M., Kummer, A. W., Bergé, S. J., & Kuijpers-Jagtman, A. M. (2018). Effect of One-Stage versus Two-Stage Palatoplasty on Hypernasality and Fistula Formation in Children with Complete Unilateral Cleft Lip and Palate: A Randomized Controlled Trial. Plastic and reconstructive surgery, 142(1), 42e–50e. https://doi.org/10.1097/PRS.0000000000004486
Salimi, N., Aleksejūnienė, J., Yen, E. H., & Loo, A. Y. (2017). Fistula in Cleft Lip and Palate Patients-A Systematic Scoping Review. Annals of plastic surgery, 78(1), 91–102. https://doi.org/10.1097/SAP.0000000000000819
Souza, M. T. de., Silva, M. D. da., & Carvalho, R. de. (2010). Integrative review: what is it? How to do it? Einstein (são Paulo), 8(1), 102–106. https://doi.org/10.1590/S1679-45082010RW1134
Shetty, V., Sreekumar, C., Patteta, N. K., Bahl, D., & Sailer, H. F. (2021). Correlation between surgical protocols for palatoplasty and midfacial growth in cleft lip and palate patients: A long-term, single centre study. Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery, 49(11), 1010–1019. https://doi.org/10.1016/j.jcms.2021.06.008
Xepoleas, M. D., Naidu, P., Nagengast, E., Collier, Z., Islip, D., Khatra, J., Auslander, A., Yao, C. A., Chong, D., & Magee, W. P., 3rd (2023). Systematic Review of Postoperative Velopharyngeal Insufficiency: Incidence and Association With Palatoplasty Timing and Technique. The Journal of craniofacial surgery, 34(6), 1644–1649. https://doi.org/10.1097/SCS.0000000000009555
Xu, X., Zheng, Q., Lu, D., Huang, N., Li, J., Li, S., Wang, Y., & Shi, B. (2012). Timing of palate repair affecting growth in complete unilateral cleft lip and palate. Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery, 40(8), e358–e362. https://doi.org/10.1016/j.jcms.2012.01.022
Ye, B., Ruan, C., Hu, J., Yang, Y., Ghosh, A., Jana, S., & Zhang, G. (2010). A comparative study on dental-arch morphology in adult unoperated and operated cleft palate patients. The Journal of craniofacial surgery, 21(3), 811–815. https://doi.org/10.1097/SCS.0b013e3181d879fa
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