The Advantages and Disadvantages of Two Stages Palatoplasty: A Systematic Review

Arya Tjipta; Hafiz Ramadhan; Rahmi Lubis

doi:10.3889/oamjms.2023.11037

Authors

Arya Tjipta Department of Reconstructive and Aesthetic Plastic Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-0905-7404
Hafiz Ramadhan General Practitioner, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-7011-3997
Rahmi Lubis Department of Public Health, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-0905-7404

DOI:

https://doi.org/10.3889/oamjms.2023.11037

Keywords:

Advantages, Disadvantages, Two stages, Palatoplasty

Abstract

BACKGROUND: Two-stage palatoplasty involves soft palate closure–6–8 months after birth, followed by hard palate closure at the age of 12–14 years to avoid early surgical intervention of the hard palate.

AIM: This study aimed to present the advantages and disadvantages of two-stage cleft repair palatoplasty.

METHODS: This study used the literature review method to find articles using the search engine Google Scholar, Ovid, and PubMed. According to the search results, 525 articles were in accordance with the title of the study, but those in accordance with the inclusion criteria amounted to nine articles only.

RESULTS: The results of several studies in this study highlight some of the advantages and disadvantages of the two-stage palatoplasty procedure in several countries.

CONCLUSIONS: Some advantages of two-stage palatoplasty are good maxillary growth and disadvantages, such as increased velopharyngeal insufficiency.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Leow AM, Lo LJ. Palatoplasty: Evolution and controversies. Chang Gung Med J. 2008;31(4):335-45. PMid:18935791

Naidu P, Yao CA, Chong DK, Magee WP 3rd. Cleft palate

repair: A history of techniques and variations. Plast Reconstr Surg Glob Open. 2022;10(3):e4019. https://doi.org/10.1097/gox.0000000000004019 PMid:35492233 DOI: https://doi.org/10.1097/GOX.0000000000004019

Agrawal K, Panda KN. Use of vomer flap in palatoplasty: Revisited. Cleft Palate Craniofac J. 2006;43(1):30-7. https://doi.org/10.1597/04-034.1 PMid:16405371 DOI: https://doi.org/10.1597/04-034.1

Schweckendiek W, Doz P. Primary veloplasty: Long-term results without maxillary deformity. A twenty-five year report. Cleft Palate J. 1978;15(3):268-74. PMid:278679

Slaughter WB, Pruzansky S. The rationale for velar closure as a primary procedure in the repair of cleft palate defects. Plast Reconstr Surg (1946). 1954;13(5):341-57. https://doi.org/10.1097/00006534-195405000-00002 PMid:13166609 DOI: https://doi.org/10.1097/00006534-195405000-00002

Madachi K, Takagi R, Asahito T, Kodama Y, Ominato R, Iida A, et al. Cephalometric evaluation after two-stage palatoplasty combined with a Hotz plate: A comparative study between the modified Furlow and Widmaier-Perko methods. Int J Oral Maxillofac Surg. 2017;46(5):539-47. https://doi.org/10.1016/j.ijom.2017.01.009 PMid:28174062 DOI: https://doi.org/10.1016/j.ijom.2017.01.009

Allori AC, Kelley T, Meara JG, Albert A, Bonanthaya K, Chapman K, et al. A standard set of outcome measures for the comprehensive appraisal of cleft care. Cleft Palate Craniofac J. 2017;54(5):540-54. https://doi.org/10.1597/15-292 PMid:27223626 DOI: https://doi.org/10.1597/15-292

Andrade C. Internal, external, and ecological validity in research design, conduct, and evaluation. Indian J Psychol Med. 2018;40(5):498-9. https://doi.org/10.4103/ijpsym.ijpsym_334_18 PMid:30275631 DOI: https://doi.org/10.4103/IJPSYM.IJPSYM_334_18

Neumann S, Romonath R. Application of the international classification of functioning, disability, and health-children and youth version (ICF-CY) to cleft lip and palate. Cleft Palate Craniofac J. 2012;49(3):325-46. https://doi.org/10.1597/10-145 PMid:22292728 DOI: https://doi.org/10.1597/10-145

Semb G, Brattstrom V, Mølsted K, Prahl-Andersen B, Zuurbier P, Rumsey N, et al. The Eurocleft study: Inter-center study of treatment outcome in patients with complete cleft lip and palate. Part 4: Relationship among treatment outcome, patient/parent satisfaction, and the burden of care. Cleft Palate Craniofac J. 2005;42(1):83-92. https://doi.org/10.1597/02-119.4.1 PMid:15643921 DOI: https://doi.org/10.1597/02-119.4.1

Brusati R, Meazzini MC, Rezzonico A, Biglioli F, Garattini G, Battista VM, et al. Evaluation of a sample of patients with unilateral cleft lip and palate treated with a two-stage protocol. J Craniofac Surg. 2018;29(8):2058-64. https://doi.org/10.1097/scs.0000000000004789 PMid:30277945 DOI: https://doi.org/10.1097/SCS.0000000000004789

Potemra HM, Lin J, Bertrand AA, De Leon FS, Alford JA, Hu AC, et al. Long-term effect of multiple operations on psychosocial function in teenage cleft lip and palate patients. Plast Reconstr Surg. 2020;146(1):61e-8. https://doi.org/10.1097/prs.0000000000006905 PMid:32590656 DOI: https://doi.org/10.1097/PRS.0000000000006905

Ozawa TO, Reis LL, Kato RM, Rocha DL, Sathler R, Garib DG. Facial and nasolabial aesthetics of complete UCLP submitted to 2-stage palate repair with vomer flap. Cleft Palate Craniofac J. 2018;55(9):1211-7. https://doi.org/10.1177/1055665618767418 PMid:29652533 DOI: https://doi.org/10.1177/1055665618767418

Eriguchi M, Watanabe A, Suga K, Nakano Y, Sakamoto T, Sueishi K, et al. Growth of palate in unilateral cleft lip and palate patients undergoing two-stage palatoplasty and orthodontic treatment. Bull Tokyo Dent Coll. 2018;59(3):183-91. https://doi.org/10.2209/tdcpublication.2017-0014 PMid:30224612 DOI: https://doi.org/10.2209/tdcpublication.2017-0014

Mizuno S, Kurita K, Imaoka K, Hanai H, Matsui Y, Katayama Y, et al. Two-stage cleft palate closure by our treatment algorithm in complete unilateral cleft lip and palate: Results of maxillary growth at 6 years of age. J Oral Maxillofac Surg Med Pathol. 2019;31(2):59-64. https://doi.org/10.1016/j.ajoms.2018.12.003 DOI: https://doi.org/10.1016/j.ajoms.2018.12.003

Chung KH, Lo LJ. One-stage versus two-stage repair of asymmetric bilateral cleft lip: A 20-year retrospective study of clinical outcome. Plast Reconstr Surg. 2018;141(5):1215-24. https://doi.org/10.1097/prs.0000000000004327 PMid:29351180 DOI: https://doi.org/10.1097/PRS.0000000000004327

Feitosa LB. Aesthetic Outcome of the Face after 2-stage Palate Repair for Complete Unilateral Cleft Lip and Palate. Doctoral Dissertation, Universidade de São Paulo; 2022.

Reddy RR, Reddy SG, Chilakalapudi A, Kokali S, Bronkhorst EM, Kummer AW, et al. 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. Plast Reconstr Surg. 2018;142(1):42e-50e. https://doi.org/10.1097/prs.0000000000004486 PMid:29652768 DOI: https://doi.org/10.1097/PRS.0000000000004486

Elkasry MT, Ghanem WA, Radwan AB, Gadallah MA, Mostafa MS, Albaghdady AA. One-stage simultaneous cleft lip and palate repair versus two-stage repair in children with complete unilateral cleft lip and palate: A randomized controlled study. Egypt J Surg. 2021;40(4):1455-61. https://doi.org/10.4103/ejs.ejs_263_21

McCrary H, Pollard SH, Torrecillas V, Khong L, Taylor HM, Meier J, et al. Increased risk of velopharyngeal insufficiency in patients undergoing staged palate repair. Cleft Palate Craniofac J. 2020;57(8):975-83. https://doi.org/10.1177/1055665620913440 PMid:32207321 DOI: https://doi.org/10.1177/1055665620913440

Sabbag A, Denadai R, Raposo-Amaral CA, Buzzo CL, Raposo- Amaral CE, Nagae MH. Electromyographic activity of the masseter and temporal muscles in patients with nonsyndromic complete unilateral cleft lip and palate: 2-stage versus 1-stage palate repair. J Craniofac Surg. 2018;29(6):1463-8. https://doi.org/10.1097/SCS.0000000000004587 PMid:29762320 DOI: https://doi.org/10.1097/SCS.0000000000004587