Does the Surgical Protocol Impact the Burden of Care of Patients With Cleft Lip and/or Palate?
Year: 2025
Type: article
Study design: Observational Study
Abstract: AIM: To compare the burden of care in the first 7 years of life of patients with cleft lip and palate (CLP) treated with 2 different surgical protocols. METHODS: The burden of care of patients with cleft palate (CP), unilateral (UCLP), and bilateral cleft lip and palate (BCLP), surgically treated with Protocol A (soft palate closure at 1 year with Veau-Wardill-Kilner pushback technique and hard palate closure between 5 and 7 years with Von Langenbeck procedure) and B (soft palate closure at 1 year with intravelar veloplasty by Sommerlad and hard palate closure using a vomer flap at time of lip repair) was compared. The burden of care was assessed from the patient's file from birth until 7 years old through the following disciplines: surgical, dental, audiological, logopedic, radiologic, and logistic. Group comparisons were performed using multivariable models with correction for confounders. Continuous and binary variables were analyzed with linear and logistic regression models respectively. RESULTS: One hundred nineteen CLP patients were included (62 CP, 40 UCLP, and 17 BCLP). Sixty-eight were treated with protocol A and 51 with protocol B. Patients treated with protocol B spent less days in the hospital after surgery ( P =0.628), had less postsurgical complications ( P <0.001), lower need for secondary interventions ( P =0.016), needed less orthodontic maxillary expansion ( P =0.004), less ventilation tube insertions ( P <0.001), less speech therapy ( P <0.001), less extractions of deciduous teeth ( P = 0.040), less consultations ( P =0.008) and traveled less distance ( P =0.019). Patients treated with protocol A were younger when their first orthopantomogram ( P <0.001) and craniofacial x-rays ( P <0.001) were taken, and these radiographs were taken more often ( P =0.013 and <0.001, respectively). CONCLUSIONS: Patients treated with protocol B experience a significantly lower burden of care in the first 7 years of life.
Source: Journal of Craniofacial Surgery
Institution: KU Leuven
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W4410160470