2026-04-13T06:57:23Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/119772025-10-24T10:20:52Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:20:52Z urn:hdl:11351/11977 Comparison of two surgical protocols for the treatment of unilateral cleft lip and palate: a multidisciplinary systematic review and meta-analysis van Roey, Victor Ombashi, Saranda Pleumeekers, Mieke M. Mathijssen, Irene Mink van der Molen, Aebele Barber MUNILL-FERRER, MONTSERRAT Llavi leporí - Cirurgia Paladar - Malformacions Protocols clínics Boca - Cirurgia ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Clinical Protocols DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Surgery, Plastic DISEASES::Musculoskeletal Diseases::Jaw Diseases::Jaw Abnormalities::Cleft Palate DISEASES::Stomatognathic Diseases::Mouth Diseases::Lip Diseases::Cleft Lip ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Oral Surgical Procedures::Orthognathic Surgical Procedures TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::protocolos clínicos DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía plástica ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades maxilomandibulares::anomalías maxilomandibulares::fisura palatina ENFERMEDADES::enfermedades estomatognáticas::enfermedades de la boca::enfermedades de los labios::labio leporino TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos orales::procedimientos quirúrgicos ortognáticos Cleft lip; Oral surgical procedures; Treatment outcome Llavi leporino; Procediments quirúrgics orals; Resultat del tractament Labio leporino; Procedimientos quirúrgicos orales; Resultado del tratamiento There is still no unanimous agreement on the optimal surgical protocol(s) for the treatment of unilateral cleft lip and palate (UCLP), and a huge variety of protocols are employed by cleft centres across the world. The aim of this systematic review and meta-analysis was to compare reported patient outcomes of the Oslo protocol (and modifications) (OP) and delayed hard palate closure protocols (DHPCP) from a multidisciplinary perspective. A systematic search of multiple databases was conducted until September 2023. Studies reporting any patient outcomes of these protocols were included. Random-effects meta-analyses were performed for evidence synthesis, including comparisons of results between the types of protocol. The quality of evidence was evaluated using the ROBINS-I tool. In total, 62 articles (42 studies) reporting patients with UCLP were reviewed, involving 1281 patients following the OP and 655 following DHPCP. Equally poor long-term sagittal maxillofacial growth was found, and similar results for velopharyngeal insufficiency and nasolabial appearance. In contrast, OP was associated with a lower rate of oronasal fistulas. Disregarding the scarcity of comparable evidence for some domains, the results of this review, overall, favour OP over DHPCP. However, caution should be taken when interpreting the results on velopharyngeal insufficiency and oronasal fistulas, since the possibility of confounding and other biases remains. Partially funded by ERN CRANIO (European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose and Throat (ENT) Disorders) in terms of personnel costs for two researchers (V. van Roey, S. Ombashi). ERN CRANIO is funded by the European Union. 2025-10-24T10:20:52Z 2025-10-24T10:20:52Z 2024-09-27T11:49:01Z 2024-09-27T11:49:01Z 2024-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/11977 International Journal of Oral and Maxillofacial Surgery;53(10) https://doi.org/10.1016/j.ijom.2024.04.003 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia