Abstract：
OBJECTIVE: To review the evidence supporting the use of buccal fat pad (BFP) in primary and secondary cleft palate repair and its short- and long- term clinical outcomes.
METHODS: Systematic review conducted by 2 independent reviewers following PRISMA guidelines.
UNASSIGNED: Articles were identified from three databases (Pubmed/Medline, Embase and Web of Science). Search terms included \"cleft palate\", \"palatoplasty\", \"palate repair\", \"buccal fat pad\".
METHODS: Use of BFP in primary and secondary cleft palatoplasty.
METHODS: Primary outcomes were immediate postoperative complications, postoperative fistula, and maxillary growth. Secondary outcomes were palatal length, speech, and donor site morbidity.
RESULTS: Ninety-one reports were retrieved after excluding duplicates. Twenty-three studies were included (13 case series and 10 comparative studies). Overall level of evidence was low. Randomized and non-randomized studies had a high risk of bias. In primary palatoplasty, BFP was more frequently used filling lateral relaxing incisions(57.4%), or in the hard-soft palate junction and covering mucosal defects(30.1%). In these patients, post operative fistula incidence was 2.8%. Two studies found wider transverse maxillary dimensions after BFP use. No higher incidence of bleeding, infection, dehiscence, or flap necrosis was reported. In secondary palatoplasty, no recurrent fistulas were reported for patients undergoing BFP for fistula repair.
CONCLUSIONS: BFP appears to be associated with a favorable impact in fistula prevention and management, as well as in transverse maxillary growth. However, there is a high heterogeneity among studies, high risk of bias and overall low quality of evidence. More high-quality research with long-term follow-up is warranted.
METHODS: Systematic review conducted by 2 independent reviewers following PRISMA guidelines.
UNASSIGNED: Articles were identified from three databases (Pubmed/Medline, Embase and Web of Science). Search terms included \"cleft palate\", \"palatoplasty\", \"palate repair\", \"buccal fat pad\".
METHODS: Use of BFP in primary and secondary cleft palatoplasty.
METHODS: Primary outcomes were immediate postoperative complications, postoperative fistula, and maxillary growth. Secondary outcomes were palatal length, speech, and donor site morbidity.
RESULTS: Ninety-one reports were retrieved after excluding duplicates. Twenty-three studies were included (13 case series and 10 comparative studies). Overall level of evidence was low. Randomized and non-randomized studies had a high risk of bias. In primary palatoplasty, BFP was more frequently used filling lateral relaxing incisions(57.4%), or in the hard-soft palate junction and covering mucosal defects(30.1%). In these patients, post operative fistula incidence was 2.8%. Two studies found wider transverse maxillary dimensions after BFP use. No higher incidence of bleeding, infection, dehiscence, or flap necrosis was reported. In secondary palatoplasty, no recurrent fistulas were reported for patients undergoing BFP for fistula repair.
CONCLUSIONS: BFP appears to be associated with a favorable impact in fistula prevention and management, as well as in transverse maxillary growth. However, there is a high heterogeneity among studies, high risk of bias and overall low quality of evidence. More high-quality research with long-term follow-up is warranted.
摘要：
目的：回顾支持颊脂肪垫（BFP）在原发性和继发性腭裂修复中的应用及其短期和长期临床结果的证据。
方法：根据PRISMA指南，由2名独立审核员进行系统审查。
■文章是从三个数据库(Pubmed/Medline，Embase和WebofScience)。搜索词包括“腭裂”，\"腭成形术\",\"腭修复\",“颊脂肪垫”。
方法：在原发性和继发性腭裂成形术中使用BFP。
方法：主要结果是术后即刻并发症，术后瘘,和上颌生长。次要结果是腭长度，演讲,和供体部位发病率。
结果：排除重复后，检索到91份报告。纳入23项研究（13项病例系列和10项比较研究）。总体证据水平较低。随机和非随机研究存在较高的偏倚风险。在原发性腭成形术中，BFP更常用于填充外侧松弛切口(57.4%)，或在硬-软腭交界处和覆盖粘膜缺损（30.1%）。在这些患者中,术后瘘发生率为2.8%。两项研究发现，使用BFP后，上颌横尺寸更宽。没有较高的出血发生率，感染,开裂，或皮瓣坏死。在二次腭成形术中，在接受BFP治疗瘘管修复的患者中,未发现复发性瘘管.
结论：BFP似乎与瘘管预防和管理的有利影响相关，以及上颌骨的横向生长。然而,研究之间存在高度异质性，偏倚风险高，总体证据质量低。有必要进行更多高质量的研究和长期随访。
方法：根据PRISMA指南，由2名独立审核员进行系统审查。
■文章是从三个数据库(Pubmed/Medline，Embase和WebofScience)。搜索词包括“腭裂”，\"腭成形术\",\"腭修复\",“颊脂肪垫”。
方法：在原发性和继发性腭裂成形术中使用BFP。
方法：主要结果是术后即刻并发症，术后瘘,和上颌生长。次要结果是腭长度，演讲,和供体部位发病率。
结果：排除重复后，检索到91份报告。纳入23项研究（13项病例系列和10项比较研究）。总体证据水平较低。随机和非随机研究存在较高的偏倚风险。在原发性腭成形术中，BFP更常用于填充外侧松弛切口(57.4%)，或在硬-软腭交界处和覆盖粘膜缺损（30.1%）。在这些患者中,术后瘘发生率为2.8%。两项研究发现，使用BFP后，上颌横尺寸更宽。没有较高的出血发生率，感染,开裂，或皮瓣坏死。在二次腭成形术中，在接受BFP治疗瘘管修复的患者中,未发现复发性瘘管.
结论：BFP似乎与瘘管预防和管理的有利影响相关，以及上颌骨的横向生长。然而,研究之间存在高度异质性，偏倚风险高，总体证据质量低。有必要进行更多高质量的研究和长期随访。
