Frequency of pharyngoplasty after primary repair of cleft palate.
Bibliographic record
Abstract
BACKGROUND: The frequency of pharyngoplasty after initial repair of cleft palate is a direct measure of the success or failure of the primary palatal repair with respect to velopharyngeal function. The optimal timing and surgical technique for the repair of cleft palate remain subjects of debate. PURPOSE: To assess the outcome of various techniques for primary palatal repair, specifically the frequency of secondary pharyngoplasty, and to determine the significance, if any, of certain variables to this outcome. METHODS: A pool of 114 patients with cleft lip and palate was compiled from a retrospective analysis of medical records for more than 300 consecutive patients treated over a 15-year period (1980-1995). The review included only patients who had been treated by the same surgeon or by his resident. A 1-stage palatal repair was performed on all patients, in which the hard and the soft palate were closed simultaneously. The following data were collected: patient's sex, patient's date of birth, type of cleft, technique used for initial repair, age at initial repair and date of secondary pharyngoplasty surgery, if performed. RESULTS: The overall frequency of subsequent pharyngoplasty was 25% (28 patients). The rate of secondary surgery was significantly higher for boys (21/63 or 33%) than for girls (7/51 or 14%). There were also significant differences in the rate of secondary pharyngoplasty according to type of cleft: 50% (6/12) for patients with bilateral cleft lip and palate, 44% (7/16) for those with hard and soft cleft palate, 21% (8/38) for those with unilateral cleft lip and palate, 20% (3/15) for those with submucous cleft palate and 12% (4/33) for those with soft cleft palate. Surgical technique for the primary repair (V-Y pushback or von Langenbeck procedure) was not a significant factor in determining the rate of subsequent pharyngoplasty, nor was age at primary repair, although those who underwent primary repair at age 12-14 months were least likely to require pharyngoplasty. CONCLUSION: In this study the frequency of velopharyngeal insufficiency after 1-stage palatoplasty was consistent with previously reported results. Of interest would be a comparison of 1-stage and 2-stage approaches to primary palate repair in young patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".