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Reshaping Faces, Redefining Risks: A Systematic Review of Orthognathic Surgery Outcomes in Cleft Lip and Palate
Sachin R Chinta1, Sergio Segrera1, Rebecca Friedman1
1Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY 10016, USA.
Journal of Clinical Medicine
|October 16, 2024
Summary
Orthognathic surgery improves outcomes for cleft lip and palate patients, but relapse and velopharyngeal insufficiency are key risks. This systematic review informs surgical planning and patient counseling for better results.
Area of Science:
- Craniofacial Surgery
- Plastic Surgery
- Oral and Maxillofacial Surgery
Background:
- Cleft lip and palate (CLP) patients often require orthognathic surgery for definitive treatment.
- Identifying generalized outcomes and risk profiles is crucial for this patient population.
Purpose of the Study:
- To determine the generalized outcome and risk profile for CLP patients undergoing orthognathic surgery.
- To identify key risk factors associated with increased surgical risk in CLP patients.
Main Methods:
- Systematic review of literature using PubMed, MEDLINE, Cochrane, and Scopus.
- Data curation via Covidence with dual-reviewer screening and third-party conflict resolution.
- Inclusion of 62 full-text articles representing 2550 patients.
Main Results:
- Le Fort I osteotomy was the most common procedure (99%).
- Significant worsening in velopharyngeal insufficiency (63%) but improved speech articulation (33%).
- Average horizontal movement of 6.09 mm with 0.98 mm overall relapse.
Conclusions:
- Orthognathic surgery is effective for oropharyngeal and aesthetic deficits in CLP patients.
- Relapse and velopharyngeal insufficiency are significant complications requiring attention.
- Findings support refinement of surgical protocols and patient counseling.
