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Evidence summaries

Interventions for the Management of Submucous Cleft Palate

There is probably no significant difference in the effectiveness of different surgical interventions for correcting velopharyngeal insufficiency associated with submucous cleft palate. Level of evidence: "C"

A systematic review 1 included 26 studies analyzing the outcomes of surgery for velopharyngeal insufficiency (VPI) in patients with submucous cleft palate (SMCP). There were mixed etiologies within patients. In these studies, speech outcomes were measured either in a binary fashion (i.e., normal speech or evidence of VPI) or using scales of VPI severity. Only 2 studies utilized blinded speech assessment, and 12 included both preoperative and postoperative speech assessment. There was little evidence to support any specific surgical intervention.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patients) and indirectness (lack of validated pre- and postoperative speech assessment).

    References

    • Gilleard O, Sell D, Ghanem AM et al. Submucous cleft palate: a systematic review of surgical management based on perceptual and instrumental analysis. Cleft Palate Craniofac J 2014;51(6):686-95. [PubMed]

Primary/Secondary Keywords