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Interventions for the management of submucous cleft palateNasser M, Fedorowicz Z, Newton JT, Nouri M
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SummaryInterventions for the management of submucous cleft palateCleft palate (a split in the roof of the mouth) is a common congenital anomaly which affects approximately 1 in 600 people. Submucous cleft palate (SMCP) is a small subgroup of cleft palate and most of the affected people are asymptomatic. However, some of the individuals with submucous cleft palate have certain speech and resonance problems like hypernasal speech and may undergo surgery. We found only one study evaluating an uncommon surgical technique called minimal incision palatopharyngoplasty versus the same procedure performed simultaneously with an individually tailored pharyngeal flap or sphincter pharyngoplasty and the trial only provided some weak evidence that these techniques are not significantly different. In addition to this, the trial did not report adverse effects.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 23. 2008 AbstractBackgroundSubmucous cleft palate (SMCP) is a common congenital malformation of the soft palate which may present as velopharyngeal insufficiency (VPI), which can affect the quality and intelligibility of speech. Surgical techniques, which can be used to reconstruct these structural or anatomical defects and to correct velopharyngeal insufficiency, include palatal repair and procedures that rearrange the muscle attachments of the soft palate. ObjectivesTo provide reliable evidence regarding the effectiveness of surgical interventions to treat velopharyngeal insufficiency and improve speech in patients with submucous cleft palate. Search strategyWe searched the Cochrane Oral Health Group Trials Register (to 21st December 2006); Cochrane Developmental, Psychosocial and Learning Problems Group Trials Register (on 12th March 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 4); MEDLINE (from 1966 to 21st December 2006); EMBASE (from 1980 to 21st December 2006); and CINAHL, ERIC, PsycINFO (on 7th March 2007). Selection criteriaRandomised controlled trials comparing surgical interventions to correct velopharyngeal insufficiency in submucous cleft palate. Data collection and analysisLimited data from one included trial precluded pooling of data, and only a descriptive summary is presented. Main resultsThis review included one trial, involving 72 participants aged 4 to 7 years with submucous cleft palate associated velopharyngeal insufficiency, which compared minimal incision palatopharyngoplasty (MIPP) to MIPP with additional velopharyngeal surgery, either pharyngeal flap (32) or sphincter pharyngoplasty (3). Authors' conclusionsThe trial provided some weak and unreliable evidence that there was no significant difference in the effectiveness of minimal incision palatopharyngoplasty versus the same procedure performed simultaneously with an individually tailored pharyngeal flap or sphincter pharyngoplasty for correcting velopharyngeal insufficiency associated with submucous cleft palate. |