title: Update on outcomes research for cleft lip and palate.
abstract: OBJECTIVE
  The purpose of this review is to summarize the recent evidence-based literature focusing on cleft lip and palate outcomes research.
  
  
  RESULTS
  The findings of recently published literature focus on cleft lip and palate outcomes research, patient-based outcomes measurement tools, nasoalveolar molding, and how speech outcomes relate to palatoplasty timing, technique, and intravelar veloplasty. Studies have investigated the relationship between palatoplasty timing and facial development.
  
  
  CONCLUSIONS
  The literature lacks any evidence-based consensus to support a superior method of cleft lip repair. A majority of North American surgeons, however, utilize a rotation-advancement technique and perform cleft rhinoplasty at the time of primary lip repair, with the idea that this could decrease the number of revision surgeries needed over the long term. Most cleft surgeons perform a single-stage palatoplasty at 9-12 months of age for improved early speech outcomes. There is insufficient evidence to support a two-stage palatoplasty with the intention of improved maxillary growth. Controversy persists on the relationship between early palatal surgery and its deleterious effects on facial development. A shift toward patient-reported outcomes is called for; however, this remains difficult, as there are few validated, cleft-specific outcome measurement tools.
authors.affiliation: Division of Facial Plastic & Reconstructive Surgery, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: David
authors.initials: D
authors.lastname: Shaye
mesh_terms: D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D057186:Comparative Effectiveness Research; D006801:Humans; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012225:Rhinoplasty; D016896:Treatment Outcome