Current concepts in cleft care: A multicenter analysis

Oliver C Thiele; Matthias Kreppel; Anton Dunsche; Andre M Eckardt; Michael Ehrenfeld; Bernd Fleiner; Volker Gaßling; Gerd Gehrke; Marcus Gerressen; Martin Gosau; Alexander Gröbe; Stefan Haßfeld; Max Heiland; Bodo Hoffmeister; Frank Hölzle; Cornelius Klein; Maximilian Krüger; Alexander C Kübler; Norbert R Kübler; Johannes J Kuttenberger; Constantin Landes; Günter Lauer; Markus Martini; Erich T Merholz; Robert A Mischkowski; Bilal Al-Nawas; Emeka Nkenke; Jörn U Piesold; Winnie Pradel; Michael Rasse; Martin Rachwalski; Rudolf H Reich; Daniel Rothamel; Jan Rustemeyer; Martin Scheer; Henning Schliephake; Rainer Schmelzeisen; Alexander Schramm; Wiebke Schupp; Wolfgang J Spitzer; Erwin Stocker; Christian Stoll; Hendrik Terheyden; Alexander Voigt; Wilfried Wagner; Dieter Weingart; Richard Werkmeister; Jörg Wiltfang; Christoph M Ziegler; Joachim E Zöller

doi:10.1016/j.jcms.2018.01.014

Current concepts in cleft care: A multicenter analysis

J Craniomaxillofac Surg. 2018 Apr;46(4):705-708. doi: 10.1016/j.jcms.2018.01.014. Epub 2018 Feb 6.

Authors

Oliver C Thiele¹, Matthias Kreppel², Anton Dunsche³, Andre M Eckardt⁴, Michael Ehrenfeld⁵, Bernd Fleiner⁶, Volker Gaßling⁷, Gerd Gehrke⁸, Marcus Gerressen⁹, Martin Gosau¹⁰, Alexander Gröbe¹¹, Stefan Haßfeld¹², Max Heiland¹¹, Bodo Hoffmeister¹³, Frank Hölzle¹⁴, Cornelius Klein¹⁵, Maximilian Krüger¹⁶, Alexander C Kübler¹⁷, Norbert R Kübler¹⁸, Johannes J Kuttenberger¹⁹, Constantin Landes²⁰, Günter Lauer²¹, Markus Martini²², Erich T Merholz²³, Robert A Mischkowski²⁴, Bilal Al-Nawas¹⁶, Emeka Nkenke²⁵, Jörn U Piesold²⁶, Winnie Pradel²¹, Michael Rasse²⁷, Martin Rachwalski²⁸, Rudolf H Reich²², Daniel Rothamel², Jan Rustemeyer²⁹, Martin Scheer³⁰, Henning Schliephake³¹, Rainer Schmelzeisen³², Alexander Schramm³³, Wiebke Schupp³², Wolfgang J Spitzer³⁴, Erwin Stocker⁶, Christian Stoll³⁵, Hendrik Terheyden³⁶, Alexander Voigt¹³, Wilfried Wagner¹⁶, Dieter Weingart³⁷, Richard Werkmeister³⁸, Jörg Wiltfang⁷, Christoph M Ziegler³⁹, Joachim E Zöller²

Affiliations

¹ Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, (Head: Prof. R. A. Mischkowski, MD, DDS), Germany. Electronic address: thieleo@klilu.de.
² Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, (Head: Prof. J.E. Zöller, MD, DDS), Germany.
³ Department of Oral and Maxillofacial Surgery, City Hospital Karlsruhe, (Head: Prof. A. Dunsche, MD, DDS), Germany.
⁴ Department of Oral and Maxillofacial Surgery, Bremerhaven Hospital, (Head: Prof. A. Eckardt, MD, DDS, MBA), Germany.
⁵ Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, (Head: Prof. M. Ehrenfeld, MD, DDS), Germany.
⁶ Oral and Maxillofacial Surgery, Im Pferseepark, (Head: B. Fleiner & E. Stocker, MD, DDS, MSc), Augsburg, Germany.
⁷ Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, (Head: Prof. J. Wiltfang, MD, DDS), Germany.
⁸ Department of Oral and Maxillofacial Surgery, Henrietten Foundation Hospital, (Head: Prof. G. Gehrke, MD, DDS), Hannover, Germany.
⁹ Department of Oral, Maxillofacial and Plastic Facial Surgery, Heinrich-Braun Hospital Zwickau, (Head: PD M. Gerressen, MD, DDS), Germany.
¹⁰ Department of Oral and Maxillofacial Surgery, Nuremberg Hospital, (Head: Prof. M. Gosau, MD, DDS), Germany.
¹¹ Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, (Head: Prof. M. Heiland, MD, DDS), Germany.
¹² Department of Craniomaxillofacial Surgery-Plastic Surgery, University Witten/Herdecke, Hospital Dortmund, (Head: Prof. S. Haßfeld, MD, DDS), Germany.
¹³ Department of Oral and Maxillofacial Surgery, Charité University Medicine, (Head: Prof. B. Hoffmeister, MD, DDS), Berlin, Germany.
¹⁴ Department of Oral, Maxillofacial and Plastic Facial Surgery, RWTH Aachen University Hospital, (Head: Prof. F. Hölzle, MD, DDS), Germany.
¹⁵ Department of Oral and Maxillofacial Surgery, Donauisar Hospital Deggendorf, (Head: Prof. C. Klein, MD, DDS), Germany.
¹⁶ Department of Oral and Maxillofacial Surgery, University Hospital Mainz, (Head: Prof. W. Wagner, MD, DDS), Germany.
¹⁷ Department of Oral and Maxillofacial Plastic Surgery, University of Würzburg, (Head: Prof. A.C. Kübler, MD, DDS), Germany.
¹⁸ Department of Cranio- and Maxillofacial Surgery, Heinrich-Heine-University Düsseldorf, (Head: Prof. N.R. Kübler, MD, DDS), Germany.
¹⁹ Department of Oral and Maxillofacial Surgery, Luzerner Kantonsspital, (Head: PD J. J. Kuttenberger, MD, DDS), Switzerland.
²⁰ Department of Oral and Maxillofacial Surgery, Sana Hospital Offenbach, (Head: Prof. C. Landes, MD, DDS), Germany.
²¹ Department of Oral and Maxillofacial Surgery, Faculty of Medicine "Carl Gustav Carus", Technische Universität Dresden, (Head: Prof. G. Lauer, MD, DDS), Germany.
²² Department of Oral & Maxillofacial Plastic Surgery, University of Bonn, (Head: Prof. R. Reich, MD, DDS), Germany.
²³ Department of Oral and Maxillofacial Surgery, St. Lukas Hospital, (Head: E.T. Merholz, MD, DDS), Solingen, Germany.
²⁴ Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, (Head: Prof. R. A. Mischkowski, MD, DDS), Germany.
²⁵ Department of Oral and Maxillofacial Surgery, Medical University of Vienna, (Head: Prof. E. Nkenke, MD, DDS, MA), Austria.
²⁶ Department of Oral and Maxillofacial Surgery, Helios Hospital Erfurt, (Head: PD J.U. Piesold, MD, DDS), Germany.
²⁷ Department for Cranio-, Maxillofacial and Oral Surgery, Medical University Innsbruck, (Head: Prof. M. Rasse, MD, DDS), Austria.
²⁸ Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, (Head: Prof. J.E. Zöller, MD, DDS), Germany; National Reference Center for Cleft and Craniofacial Malformations, Department of Maxillofacial and Plastic Surgery, Hopital Universitaire Necker - Enfants Malades, (Head: Prof. E. Arnaud, MD), Paris, France.
²⁹ Department of Oral and Maxillofacial Surgery, Klinikum Bremen-Mitte, School of Medicine, University of Göttingen, (Head: Prof. J. Rustemeyer, MD, DDS), Bremen, Germany.
³⁰ Department of Oral and Maxillofacial Surgery, Hospital Minden, (Head: PD M. Scheer, MD, DDS), Germany.
³¹ Department of Oral and Maxillofacial Surgery, George-Augusta-University, (Head: Prof. H. Schliephake, MD, DDS), Göttingen, Germany.
³² Department of Oral and Maxillofacial Surgery, University Hospital of Freiburg, (Head: Prof. R. Schmelzeisen, MD, DDS), Freiburg, Germany.
³³ Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital of Ulm and University Hospital Ulm, (Head: Prof. A. Schramm, MD, DDS), Germany.
³⁴ Department for Oral and Maxillofacial Surgery, University Clinic of Saarland, (Head: Prof. W. Spitzer, MD, DDS), Homburg/Saar, Germany.
³⁵ Department of Oral and Maxillofacial Surgery, Ruppiner Kliniken, (Head: Prof. C. Stoll, MD, DDS), Neuruppin, Germany.
³⁶ Department of Oral and Maxillofacial Surgery, Red Cross Hospital, (Head: Prof. H. Terheyden, MD, DDS), Kassel, Germany.
³⁷ Department of Oral and Maxillofacial Surgery, Katharinen Hospital, (Head: Prof. D. Weingart, MD, DDS), Stuttgart, Germany.
³⁸ Department of Oral and Maxillofacial Surgery, Central German Armed Forces Hospital, (Head: Prof. R. Werkmeister, MD, DDS), Koblenz, Germany.
³⁹ Department of Oral and Maxillofacial Surgery, St Olavs University Hospital, Norwegian University for Science and Technology, (Head: Prof. C. Ziegler, MD, DDS), Trondheim, Norway.

PMID: 29526412
DOI: 10.1016/j.jcms.2018.01.014

Abstract

The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.

Keywords: Cleft lip; Cleft palate; Oral and maxillofacial surgery; Plastic surgery.

Publication types

Multicenter Study

MeSH terms

Age Factors
Cleft Lip / surgery*
Cleft Palate / surgery*
Germany
Humans
Infant
Practice Patterns, Physicians'
Surgery, Oral / methods
Surgery, Oral / statistics & numerical data*
Surveys and Questionnaires