ANALYSIS OF THE EFFECTIVENESS OF SURGICAL METHODS IN THE TREATMENT OF CLEFT PALATE

Cleft palate is one of the most significant congenital craniofacial anomalies and remains an important clinical and public health concern. The incidence of cleft palate continues to increase in many regions worldwide, highlighting the need for effective surgical management and improved treatment strategies. The primary goal of palatoplasty is the anatomical restoration of palatal integrity to enable normal speech development while minimizing the risk of oronasal fistula formation and promoting long-term harmonious growth of the facial skeleton.

This study aimed to evaluate and compare the effectiveness of different palatoplasty techniques in children with cleft palate based on functional, anatomical, and aesthetic outcomes.

The systematic review was conducted based on an analysis of English-language publications published between 1980 and 2026. A comprehensive literature search was performed in major international bibliographic databases to identify relevant studies on palatoplasty techniques in patients with cleft palate. The literature search was conducted in the following electronic databases: MEDLINE (via PubMed), EMBASE, the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. In addition, the reference lists of the included studies were manually screened to identify additional relevant publications.

A total of 47 studies were included in the systematic review, of which 26 studies were included in the meta-analysis, while the remaining studies were analyzed qualitatively. The meta-analysis of oronasal fistula incidence showed extremely high heterogeneity among studies (I²=98.8%). The pooled standardized mean difference was 1.64 (95% CI: -2.49 to 5.57; p=0.437). The pooled standardized mean difference for hypernasality was 0.50 (95% CI: -0.49 to 1.48; p=0.3227). The analysis of soft palate length showed very high heterogeneity among studies (I²=96.9%). The pooled standardized mean difference was 0.22 (95% CI: -2.40 to 2.84; p=0.87).

The meta-analysis suggests that functional outcomes of palatoplasty are mainly influenced by the quality of surgical reconstruction, accurate muscle repositioning, tissue tension and surgeon experience, while the specific surgical technique appears to play a secondary role.