Summary
Background
Velopharyngeal insufficiency (VPI) has been reported in 5–20% of patients following
cleft palate repair. Since VPI can limit communication, determining which operative
procedure leads to the greatest improvement is of utmost importance. Since there is
no consensus, this meta-analysis aims to determine which procedure results in the
most significant resolution of VPI.
Methods
Two independent assessors undertook a literature review for articles that compare
procedures aimed at treating VPI. Study quality was determined using validated scales.
Level of agreement was assessed using intra-class coalition coefficient analysis.
The heterogeneity between studies was evaluated using I2 and Cochran’s Q-statistic. Random effect model analysis and forest plots were used
to report a pooled odds ratio (OR) and 95% confidence intervals (CI) for treatment
effect. A p-value of 0.05 was considered for statistical significance.
Results
Two randomised controlled trials (RCTs) comparing pharyngeal flap to sphincter pharyngoplasty
were obtained. A total of 133 patients were included, with follow-ups at 3–4 months.
The pooled OR was determined to be 2.95 (95% CI: 0.66–13.23) in favour of the pharyngeal
flap.
Conclusions
Based on these RCTs, which currently compose the highest quality data that compares
pharyngeal flap versus pharyngoplasty, the pooled treatment effect suggests a possible
trend favouring pharyngeal flap.
Keywords
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Article info
Publication history
Published online: March 29, 2012
Accepted:
January 26,
2012
Received:
September 20,
2011
Footnotes
☆Presented at: The 16th Congress of the International Confederation for Plastic Reconstructive and Aesthetic Surgery, Vancouver, Canada (May 22nd–27th 2011).
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
