Orthognathic Surgery Rate in Cleft Care.
J Craniofac Surg
; 33(1): 87-92, 2022.
Article
in En
| MEDLINE
| ID: mdl-34967515
ABSTRACT
PURPOSE:
To determine the true need for orthognathic surgery in patients with repaired cleft lip and/or palate (CL/P) at a high-volume craniofacial center.METHODS:
An institutional retrospective review of patients with CL/P born between 1975 and 2008 was performed. Patients with adequate documentation reflecting cleft care who wereâ≥â18âyears at the time of last craniofacial/dentistry follow-up were included. Patients with non-paramedian clefts or a comorbid craniofacial syndrome were excluded. Primary outcome variable was the total proportion of patients with CL/P who either underwent or were referred for orthognathic surgery Le Fort I (LF1) to correct midface hypoplasia. Secondary outcome variables were associations between cleft phenotype, midface hypoplasia severity, and number of cleft related surgeries with the eventual LF1âreferral/recipiency.RESULTS:
One hundred seventy-seven patients with CL/P met inclusion criteria. A total of 90/177 (51%) patients underwent corrective LF1; however, 110/177 (62%) of patients were referred for surgery. Patients with secondary cleft palate involvement were referred for and underwent LF1 at significantly greater rates than those without secondary palate involvement (referred 65% versus 13%, Pâ=â0.001; underwent 55% versus 0%, Pâ<â0.001). Patients with bilateral cleft lip/palate were referred for and underwent LF1 at significantly higher rates than those with unilateral cleft lip/palate (referred 71.0% versus 50.4%, P=â0.04; underwent 84% versus 71%, Pâ=â0.02). Number of secondary palate surgeries was positively correlated with increased LF1 referral (Pâ=â0.02) but not LF1 recipiency (Pâ=â0.15).CONCLUSIONS:
The incidence of orthognathic surgery redundant in patients with repaired CL/P was 51% at our institution, marginally above the higher end of previously reported rates. However, this number is an underrepresentation of the true requirement for LF1 as 62% of patients were referred for surgical intervention of midface hypoplasia. This distinction should be considered when counseling families.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cleft Lip
/
Cleft Palate
/
Orthognathic Surgery
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Craniofac Surg
Journal subject:
ODONTOLOGIA
Year:
2022
Type:
Article