Orofacial myofunctional assessment protocols for cleft lip and palate
systematic review
DOI:
https://doi.org/10.23925/2176-2724.2024v36i3e66169Keywords:
Cleft Lip, Cleft Palate, Stomatognathic System, Stomatognathic System Abnormalities, Speech, Language and Hearing SciencesAbstract
Introduction: Cleft Lip and Palate are congenital malformations that affect the lips and/or palate and compromise other orofacial structures and functions. The orofacial myofunctional alterations caused by clefts are specific to the malformation and require a comprehensive and specific evaluation of the stomatognathic system. Objective: The objective of this systematic review is to identify the orofacial myofunctional assessment protocols for cleft lip and palate and to verify the specific variables for the assessment of this malformation. Methods: This systematic review followed the recommendations of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses”, approved by the COMPESQ of the educational institution and registered in PROSPERO. The search strategy for the review was guided by the “PICO” strategy. Searches were conducted in the following databases (between 2010 and May 2020): MEDLINE (PubMed), LILACS, Web of Science, EMBASE, CINAHL, and Scielo. Cross-sectional observational studies, cohort studies, case-control studies, and clinical trials were included, with instruments for orofacial myofunctional evaluation for cleft lip and palate in English, Spanish, and Portuguese languages. The “Study Quality Assessment Tools” were used to assess the quality of observational studies. Results: Three articles with protocols for orofacial myofunctional evaluation among the population with cleft lip and palate were included. The variables considered specific in the comparison of protocols were lips, tongue, teeth, cheeks, hard palate, labial, and lingual mobility. Conclusion: This systematic review identified three orofacial myofunctional assessment protocols for individuals with cleft lip and palate, focusing on the evaluation of the structures of the lips, tongue, soft and hard palate, cheeks, teeth, and labial and lingual mobility. The comparison of frequent items with the AMIOFE-A protocol indicated the absence of essential variables such as: FLP classification, scar characteristics, evaluation of the lingual frenulum, number of teeth, presence and appearance of the uvula and palatine tonsils, mobility of the soft palate and pharynx, as well as specific aspects of speech and velopharyngeal function. It is recommended to create a comprehensive instrument that assesses orofacial functions, structures, mobility, tonicity, and sensitivity. This would aid in the development of precise therapeutic plans and improve the quality of research. Furthermore, future studies should standardize the age ranges of samples to allow for more accurate comparisons and widely applicable protocols.
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