Alexander T Plonkowski, Dylan G Choi, Priyanka Naidu, Marvee Turk, Caroline A Yao, William P Magee
{"title":"The Rate of Secondary Speech Surgery After Cleft Palate Repair: A Systematic Review.","authors":"Alexander T Plonkowski, Dylan G Choi, Priyanka Naidu, Marvee Turk, Caroline A Yao, William P Magee","doi":"10.1097/GOX.0000000000006465","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Reported rates of velopharyngeal insufficiency (VPI) after primary palatoplasty for cleft palate (CP) range from 5% to 30%. Although some cases are managed with speech therapy, many patients with VPI require surgical intervention. In this study, we investigate the rate of VPI surgery in patients with CP.</p><p><strong>Methods: </strong>A systematic review was undertaken following PRISMA guidelines. PubMed, Scopus, and Cochrane databases were used. Studies reporting the rate of VPI surgery in patients with CP were included. Studies containing patients with submucous clefts and/or lacking 6 months follow-up were excluded. Rates of VPI surgery were calculated through weighted means.</p><p><strong>Results: </strong>Fifty-eight articles were included. The overall rate of VPI surgery was 17.5% ± 9.2% (range, 0%-59%). When stratified by phenotype, the rate of VPI surgery was 20.0% ± 13.1% for unilateral cleft lip and palate (range, 0%-39.6%), 27.1% ± 17.2% for bilateral cleft lip and palate (range, 0%-59%), and 14.4% ± 7.2% for isolated CP (range, 0%-47.4%, <i>P</i> > 0.05). When segregated by the palatoplasty technique, the surgical rate was 7.2% ± 3.7% for Furlow, 20.3% ± 19.8% for 2-flap, 5.0% ± 2.8% for Sommerlad, and 23.4% ± 8.0% for 2-stage (<i>P</i> > 0.05). Of studies reporting VPI assessment criteria, speech pathology assessment alone (n = 11, 34.4%) was the most common.</p><p><strong>Conclusions: </strong>Significant variability exists in reported rates of VPI surgery after CP repair. Initial results suggest a higher rate of VPI surgery in association with certain phenotypes and repair techniques, but data are insufficient for robust conclusions.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6465"},"PeriodicalIF":1.5000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850049/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and Reconstructive Surgery Global Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/GOX.0000000000006465","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Reported rates of velopharyngeal insufficiency (VPI) after primary palatoplasty for cleft palate (CP) range from 5% to 30%. Although some cases are managed with speech therapy, many patients with VPI require surgical intervention. In this study, we investigate the rate of VPI surgery in patients with CP.
Methods: A systematic review was undertaken following PRISMA guidelines. PubMed, Scopus, and Cochrane databases were used. Studies reporting the rate of VPI surgery in patients with CP were included. Studies containing patients with submucous clefts and/or lacking 6 months follow-up were excluded. Rates of VPI surgery were calculated through weighted means.
Results: Fifty-eight articles were included. The overall rate of VPI surgery was 17.5% ± 9.2% (range, 0%-59%). When stratified by phenotype, the rate of VPI surgery was 20.0% ± 13.1% for unilateral cleft lip and palate (range, 0%-39.6%), 27.1% ± 17.2% for bilateral cleft lip and palate (range, 0%-59%), and 14.4% ± 7.2% for isolated CP (range, 0%-47.4%, P > 0.05). When segregated by the palatoplasty technique, the surgical rate was 7.2% ± 3.7% for Furlow, 20.3% ± 19.8% for 2-flap, 5.0% ± 2.8% for Sommerlad, and 23.4% ± 8.0% for 2-stage (P > 0.05). Of studies reporting VPI assessment criteria, speech pathology assessment alone (n = 11, 34.4%) was the most common.
Conclusions: Significant variability exists in reported rates of VPI surgery after CP repair. Initial results suggest a higher rate of VPI surgery in association with certain phenotypes and repair techniques, but data are insufficient for robust conclusions.
期刊介绍:
Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.