Double opposing Z-Plasty outcome in treatment of VPI: updated meta-analysis study

Document Type : Meta-Analysis

Authors

Department of Plastic Surgery and Burns, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

10.21608/aimj.2025.398454.2584

Abstract

Background: The incomplete closure of the velopharyngeal port, which is the passageway between the oro- and nasopharynx, is referred to as velopharyngeal insufficiency (VPI).
Aim: To assess the functional results of the double opposing Z-plasty procedure for the management of VPI. This assessment was achieved through an updated meta-analysis of the recently published articles from the last years (2018-2024).
Methods: This research was dependent on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and guidelines. The authors searched for recent clinical trials, cohort trials, and prospective and retrospective comparative cohort research for this study.
Results: In this meta-analysis focusing on the impact of Double Opposing Z-Plasty on speech intelligibility in cases with velopharyngeal insufficiency, the findings highlight a modest improvement. The pooled estimate from a continuous random-effects model is 0.795 with a 95% confidence interval varying from 0.383 to 1.206, demonstrating statistically significant results (p-value under 0.001). The meta-analysis on the necessity for revision surgery following double opposing Z-plasty in the management of velopharyngeal insufficiency demonstrates a relatively low overall proportion of cases requiring further surgical intervention.
Conclusion: The findings suggest that Double Opposing Z-Plasty is a valuable option for VPI but emphasize the need for standardized success criteria, long-term follow-up, and further research to improve patient selection and surgical techniques.

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