Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2025
The rate of revision surgery for secondary deformities of the lip in cleft lip patients: A systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Plonkowski Alexander T, Choi Dylan G, Turk Marvee, Daiem Muhammad, Calderon Francesca, Naidu Priyanka, Magee William P
Аннотация
INTRODUCTION: Secondary deformities following primary cleft lip repair require varying degrees of surgical intervention, from minor scar revision to complete takedown and repair. Revision surgery can itself necessitate multiple interventions, representing a considerable burden for both patients and the health system. In this study, we evaluate the reported rates of revision surgery for secondary deformities of the lip within the literature.
METHODS: A systematic review was conducted following PRISMA criteria. Pubmed, SCOPUS, and Cochrane databases were utilized. Studies reporting rates of lip revision surgery were included. Studies with non-cleft patients, not in English, or those with primary and revision surgery at two different institutions were excluded.
RESULTS: Thirty-four studies were included. The overall revision rate was 21.2±14.6% (Range: 0-91.2%). Stratified by phenotype, revision rates were 32.3±18.9% for isolated unilateral cleft lip, 78.6±6.5% for isolated bilateral cleft lip, 29.6±24.4% for unilateral cleft lip and palate, and 36.7±21.6% for bilateral cleft lip and palate. No significant differences were found between phenotypic groups. Revision rates did not significantly differ between studies that used presurgical orthopedics (16.6±13.6%) and those that did not (25.3±9.5%) (p=0.06). With regards to surgical technique, revision rates were 27.3±19.0% for rotation advancement, 12.0±22.4% for straight line repair, and 8.1±0.5% for anatomic subunit approximation (p=0.63). The most common surgical indication was scar revision (26.2%).
CONCLUSION: Current literature reports a wide range of rates for revision surgery. The most common indication for secondary surgery is scar revision. Improved reporting of surgical technique is necessary to guide evidence-based protocols for primary lip repair.
METHODS: A systematic review was conducted following PRISMA criteria. Pubmed, SCOPUS, and Cochrane databases were utilized. Studies reporting rates of lip revision surgery were included. Studies with non-cleft patients, not in English, or those with primary and revision surgery at two different institutions were excluded.
RESULTS: Thirty-four studies were included. The overall revision rate was 21.2±14.6% (Range: 0-91.2%). Stratified by phenotype, revision rates were 32.3±18.9% for isolated unilateral cleft lip, 78.6±6.5% for isolated bilateral cleft lip, 29.6±24.4% for unilateral cleft lip and palate, and 36.7±21.6% for bilateral cleft lip and palate. No significant differences were found between phenotypic groups. Revision rates did not significantly differ between studies that used presurgical orthopedics (16.6±13.6%) and those that did not (25.3±9.5%) (p=0.06). With regards to surgical technique, revision rates were 27.3±19.0% for rotation advancement, 12.0±22.4% for straight line repair, and 8.1±0.5% for anatomic subunit approximation (p=0.63). The most common surgical indication was scar revision (26.2%).
CONCLUSION: Current literature reports a wide range of rates for revision surgery. The most common indication for secondary surgery is scar revision. Improved reporting of surgical technique is necessary to guide evidence-based protocols for primary lip repair.