Abstract：
OBJECTIVE: In cleft palate patients, the soft palate is commonly closed using straight-line palatoplasty, Z-palatoplasty, or palatoplasty with buccal flaps. Currently, it is unknown which surgical technique is superior regarding speech outcomes. The aim of this review is to study the incidence of speech correcting surgery (SCS) per soft palatoplasty technique and to identify variables which are associated with this outcome.
METHODS: A systematic literature search was carried out according to the PRISMA guidelines. Inclusion and exclusion criteria were applied to focus on the incidence of SCS after soft palatoplasty. Additional variables like surgical modification, cleft morphology, syndrome, age at palatoplasty, fistula and assessment of velopharyngeal function were reported. A modified New-Ottawa Scale (NOS) was used for quality appraisal. Pooled estimates from the meta-analysis were calculated using a random-effects model.
RESULTS: One thousand twenty-nine studies were found of which 54 were included in the analysis. The pooled estimate proportion of SCS after straight-line palatoplasty was 19% (95% CI 15-24), after Z-palatoplasty 6% (95% CI 4-9), and after palatoplasty with buccal flaps 7% (95% CI 4-11).
CONCLUSIONS: A lower SCS rate was found in patients receiving Z-palatoplasty when compared to straight-line palatoplasty. We propose a minimum set of outcome parameters which ideally should be included in future studies regarding speech outcomes after cleft palate repair.
CONCLUSIONS: Current literature reports highly heterogenous data regarding cleft palate repair. Our recommended set of parameters may address this inconsistency and could make intercenter comparison possible and of better quality.
METHODS: A systematic literature search was carried out according to the PRISMA guidelines. Inclusion and exclusion criteria were applied to focus on the incidence of SCS after soft palatoplasty. Additional variables like surgical modification, cleft morphology, syndrome, age at palatoplasty, fistula and assessment of velopharyngeal function were reported. A modified New-Ottawa Scale (NOS) was used for quality appraisal. Pooled estimates from the meta-analysis were calculated using a random-effects model.
RESULTS: One thousand twenty-nine studies were found of which 54 were included in the analysis. The pooled estimate proportion of SCS after straight-line palatoplasty was 19% (95% CI 15-24), after Z-palatoplasty 6% (95% CI 4-9), and after palatoplasty with buccal flaps 7% (95% CI 4-11).
CONCLUSIONS: A lower SCS rate was found in patients receiving Z-palatoplasty when compared to straight-line palatoplasty. We propose a minimum set of outcome parameters which ideally should be included in future studies regarding speech outcomes after cleft palate repair.
CONCLUSIONS: Current literature reports highly heterogenous data regarding cleft palate repair. Our recommended set of parameters may address this inconsistency and could make intercenter comparison possible and of better quality.
摘要：
目的：在腭裂患者中，软腭通常使用直线腭成形术闭合，Z-腭成形术,或者用颊瓣进行腭成形术。目前,尚不清楚哪种手术技术在言语结局方面更优越。这篇综述的目的是研究每种软腭成形术技术的言语矫正手术（SCS）的发生率，并确定与该结果相关的变量。
方法：根据PRISMA指南进行了系统的文献检索。纳入和排除标准用于关注软腭成形术后SCS的发生率。其他变量，如手术修改，裂隙形态,综合征,腭成形术的年龄，报告了瘘管和咽喉功能评估。使用改良的新渥太华量表（NOS）进行质量评估。荟萃分析的汇总估计值是使用随机效应模型计算的。
结果：共发现29项研究，其中54项被纳入分析。直线腭成形术后SCS的汇总估计比例为19%(95%CI15-24)，Z-pal成形术后6%（95%CI4-9），术后有7%的颊侧皮瓣(95%CI4-11)。
结论：在接受Z-pal移植的患者中，与直线pal移植相比，SCS发生率较低。我们提出了一组最小的结果参数，理想情况下应将其纳入有关left裂修复后语音结果的未来研究中。
结论：目前文献报道了关于腭裂修复的高度异质性数据。我们推荐的参数集可以解决这种不一致性，并且可以使中心间比较成为可能并且质量更好。
方法：根据PRISMA指南进行了系统的文献检索。纳入和排除标准用于关注软腭成形术后SCS的发生率。其他变量，如手术修改，裂隙形态,综合征,腭成形术的年龄，报告了瘘管和咽喉功能评估。使用改良的新渥太华量表（NOS）进行质量评估。荟萃分析的汇总估计值是使用随机效应模型计算的。
结果：共发现29项研究，其中54项被纳入分析。直线腭成形术后SCS的汇总估计比例为19%(95%CI15-24)，Z-pal成形术后6%（95%CI4-9），术后有7%的颊侧皮瓣(95%CI4-11)。
结论：在接受Z-pal移植的患者中，与直线pal移植相比，SCS发生率较低。我们提出了一组最小的结果参数，理想情况下应将其纳入有关left裂修复后语音结果的未来研究中。
结论：目前文献报道了关于腭裂修复的高度异质性数据。我们推荐的参数集可以解决这种不一致性，并且可以使中心间比较成为可能并且质量更好。
