Cleft Palate-Craniofacial Journal最新文献

{"title":"Comprehensive Long-Term Outcomes Following Mandibular Distraction Osteogenesis.","authors":"Mychajlo S Kosyk, Lauren K Salinero, Carrie Z Morales, Sameer Shakir, Christopher M Cielo, Michelle Scott, Hyun-Duck Nah, Scott P Bartlett, Jesse A Taylor, Jordan W Swanson","doi":"10.1177/10556656231206884","DOIUrl":"10.1177/10556656231206884","url":null,"abstract":"<p><strong>Objective: </strong>To describe long-term outcomes and complications following mandibular distraction osteogenesis (MDO) in a diverse patient cohort.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Single tertiary-care pediatric center.</p><p><strong>Patients: </strong>Forty-eight patients previously undergoing MDO with minimum 4-year follow-up.</p><p><strong>Main outcome measures: </strong>Respiratory outcomes, feeding patterns, dental development, motor/sensory nerve function, temporo-mandibular joint function, and postsurgical scarring.</p><p><strong>Results: </strong>Forty-six patients with a median age of 7 years were evaluated. Of 20 nonsyndromic patients, none required additional airway procedures, none required continuous positive airway pressure (CPAP) during sleep, and 19 (95%) fed exclusively by mouth. Among 26 syndromic patients, 7 (27%) required CPAP and 8 (31%) were tube fed. Permanent first molar differences were seen in the majority of subjects; patterns of damage interfering with function were more common in syndromic (13/28, 46%) compared to nonsyndromic (5/24, 21%; <i>P</i> = .014) subjects. MDO prior to age two was associated with more frequent and worse dental damage (<i>P </i>= .001). Inferior alveolar nerve and marginal mandibular nerve function were fully intact in 37 (80%) and 39 (85%) of patients, respectively. Three patients (6%), all with associated genetic syndromes, demonstrated severe nerve impairment. By the Vancouver scar scale, ≥ 80% of surgical scars were rated in the most favorable category for each quality assessed. Temporomandibular joint dysfunction was rare.</p><p><strong>Conclusions: </strong>MDO shows highly favorable long-term respiratory, feeding, nerve, and scar outcomes in nonsyndromic patients, although permanent molar changes not precluding tooth viability are commonly seen. Patients with associated syndromes demonstrate respiratory and feeding benefits, but higher rates of dental and nerve abnormalities.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"108-116"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the Unilateral Cleft Lip Nasal Deformity: Lateral Deviation of Subnasale Is a Clinical and Morphologic Index of Unrepaired Severity.","authors":"Raymond W Tse, Thomas J Sitzman, Alexander C Allori, Russell E Ettinger, David M Fisher, Michael Bezuhly, Thomas D Samson, Stephen P Beals, Damir B Matic, Ezgi Mercan","doi":"10.1177/10556656231202173","DOIUrl":"10.1177/10556656231202173","url":null,"abstract":"<p><strong>Objective: </strong>Objective measurement of pre-operative severity is important to optimize evidence-based practices given that the wide spectrum of presentation likely influences outcomes. The purpose of this study was to determine the correlation of objective measures of form with a subjective standard of cleft severity.</p><p><strong>Design: </strong>3D images were ranked according to severity of nasal deformity by 7 cleft surgeons so that the mean rank could be used as the severity standard.</p><p><strong>Patients: </strong>45 patients with unilateral cleft lip and 5 normal control subjects.</p><p><strong>Interventions: </strong>Each image was assessed using traditional anthropometric analysis, 3D landmark displacements, and shape-based analysis to produce 81 indices for each subject.</p><p><strong>Main outcome: </strong>The correlation of objective measurements with the clinical severity standard.</p><p><strong>Results: </strong>Lateral deviation of subnasale from midline was the best predictor of severity (0.86). Other strongly-correlated anthropometric measurements included columellar angle, nostril width ratio, and lateral lip height ratio (0.72, 0.80, 0.79). Almost all shape-based measurements had tight correlation with the severity standard, however, dorsum deviation and point difference nasolabial symmetry were the most predictive (0.84, 0.82).</p><p><strong>Conclusions: </strong>Quantitative measures of severity transcend cleft type and can be used to grade clinical severity. Lateral deviation of subnasale was the best measure of severity and may be used as a surrogate of uncoupled premaxillary growth; it should be recorded as an index of pre-operative severity with every cleft lip repair. The correlation of other measures evaluated clarify treatment priorities and could potentially be used to grade outcomes.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"69-78"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Keynote Address: A Guide to Supporting Conference Speakers with Lived Experience of Cleft Lip and/or Palate.","authors":"Kenny Ardouin, Danielle McWilliams, Amanda Bates","doi":"10.1177/10556656231211684","DOIUrl":"10.1177/10556656231211684","url":null,"abstract":"<p><p>Although the value of diversity within academia and society is increasingly recognised, the role of speakers with lived experience at cleft and craniofacial conferences remains inconsistent. This perspectives article shares reflection from three academics with lived experience of cleft discussing the value of including lived experience speakers routinely within conferences and outlining common challenges and barriers to the involvement of \"experts-by-experience\". Key considerations and recommendations are offered to help conference organisers and delegates to make the most of the lived experience perspective, while ensuring the conference experience is positive for lived experience speakers.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"140-143"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone-Anchored Maxillary Protraction for Adolescents with Cleft Palate and Class III Malocclusion: A Case Series.","authors":"Madeline G Chin, Kriya E Gishen, Meiwand Bedar, Kelly X Huang, Jonnby S LaGuardia, Shahrzad Moghadam, Justine C Lee, Juliana Panchura, Libby F Wilson","doi":"10.1177/10556656231219439","DOIUrl":"10.1177/10556656231219439","url":null,"abstract":"<p><p>To describe the long-term treatment course of bone-anchored maxillary protraction (BAMP) and evaluate orthognathic surgical indications after BAMP.</p><p><p>Retrospective case series.</p><p><p>Craniofacial/Cleft Palate Program at the Orthopaedic Institute for Children in Los Angeles, CA.</p><p><p>Twelve male patients with cleft palate (CP), unilateral cleft lip and palate (UCLP), or bilateral cleft lip and palate (BCLP) and Class III malocclusion treated with BAMP (mean age: 11.4 ± 2.6 years) were included.</p><p><p>BAMP treatment was performed by placement of bone-anchored maxillary and mandibular plates connected with intraoral Class III dental elastics or maxillary plates connected to a facemask.</p><p><p>We retrospectively assessed BAMP treatment variables, including age at surgery, revision surgeries, and treatment duration. The primary goal was correction to class I occlusion.</p><p><p>Twelve patients underwent BAMP treatment for an average of 4.4 ± 2.4 years. Two patients were corrected to class I occlusion at the time of this report. Le Fort I advancement was no longer required in two patients (16.7%), it was required for nine patients (75.0%) and was completed for one patient following BAMP treatment (8.3%).</p><p><p>This preliminary report demonstrated that BAMP treatment may be associated with a minimal reduction in the requirement for Le Fort I advancement at skeletal maturity. Future studies with larger sample sizes are necessary to confirm this association.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"13-20"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electromyographic Evaluation of Masticatory Muscle Activity in Individuals with and without Cleft Lip/Palate: A Systematic Review and Meta-analysis.","authors":"Hooman Shafaee, Arezoo Jahanbin, Mahsa Ghorbani, Asma Samadi, Erfan Bardideh","doi":"10.1177/10556656231201235","DOIUrl":"10.1177/10556656231201235","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to systematically review and meta-analyze the electromyographic activity of masticatory muscles in cleft palate and non-cleft patients, and identify influencing factors.</p><p><strong>Design: </strong>Systematic Review and Meta-analysis.</p><p><strong>Patients and exposures: </strong>Patients with cleft lip/ palate.</p><p><strong>Comparison: </strong>Patients without CL/P.</p><p><strong>Main outcome measures: </strong>Electrical activity of masseter and temporalis muscles at rest and during peak activation.</p><p><strong>Results: </strong>After a comprehensive search in MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL up to December 2022, without language or date restrictions. Eligible trials were selected based on the PECO question and assessed for bias using Cochrane's ROBINS-E tool. Eight clinical trials with 474 participants were included in the review. Then relevant data was extracted from included studies using customized forms. A random-effects meta-analysis was performed to combine the results of the studies, meta-analyses showed that CL/P patients have elevated electrical activity in the masseter (<i>P</i> = .01) and temporalis (<i>P</i> = <.01) muscles at rest compared to non-cleft control patients. During maximum bite force, cleft patients exhibited a statistically significant decrease in electrical activity in both the masseter (<i>P</i> = .03) and temporalis (<i>P</i> = <.01) muscles.</p><p><strong>Conclusions: </strong>According to our meta-analysis, cleft patients exhibited increased resting muscle activity but decreased activity during maximum bite force, indicating reduced efficiency of masticatory muscles compared to non-cleft patients. These differences can be attributed to anatomical variations, compensatory mechanisms, and previous treatments.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"117-130"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LeFort I Horizontal Osteotomy: Defining the Feasibility of the \"High Osteotomy\".","authors":"Alexandra N Verzella, Andre Alcon, Jill Schechter, Pradip R Shetye, David A Staffenberg, Roberto L Flores","doi":"10.1177/10556656231202595","DOIUrl":"10.1177/10556656231202595","url":null,"abstract":"<p><strong>Objective: </strong>To define \"high osteotomy\" and determine the feasibility of performing this procedure.</p><p><strong>Design: </strong>Single institution, retrospective review.</p><p><strong>Setting: </strong>Academic tertiary referral hospital.</p><p><strong>Patients, participants: </strong>34 skeletally mature, nonsyndromic patients with unilateral CLP who underwent Le Fort I osteotomy between 2013 and 2020. Patients with cone-beam computed tomography (CBCT) scans completed both pre- (T1) and post-operatively (T2) were included. Patients with bilateral clefts and rhinoplasty prior to post-operative imaging were excluded.</p><p><strong>Interventions: </strong>Single jaw one-piece Le Fort I advancement surgery.</p><p><strong>Main outcome measures: </strong>Measurements of the superior ala and inferior turbinates were taken from the post-operative CBCT.</p><p><strong>Results: </strong>The sample included 26 males and 8 females, 12 right- and 22 left-sided clefts. The inferior turbinates are above the superior alar crease at a rate of 73.53% and 76.48% on the cleft and non-cleft sides, respectively. One (2.9%) osteotomy cut was above the level of the cleft superior alar crease, and no cuts were above the level of the non-cleft superior ala. On average, the superior ala was 2.63 mm below the inferior turbinates. The average vertical distances from the superior alar crease and the inferior turbinates to the base of the non-cleft side pyriform aperture were 12.17 mm (95% CI 4.00-20.34) and 14.80 mm (95% CI 4.61-24.98), respectively. To complete a \"high osteotomy,\" with 95% confidence, the cut should be 20.36 mm from the base of the pyriform aperture.</p><p><strong>Conclusions: </strong>A \"high\" osteotomy is not consistently possible due to the relationship between the superior alar crease and the inferior turbinate.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"63-68"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthodontic Management of Severe Hypodontia and Impacted Maxillary Second Molars in a Patient with Sotos Syndrome.","authors":"Ayaka Oka, Toshihiro Inubushi, Renshiro Kani, Takashi Yamashiro","doi":"10.1177/10556656231201834","DOIUrl":"10.1177/10556656231201834","url":null,"abstract":"<p><p>Sotos syndrome is a genetic disorder characterized by distinct craniofacial features, overgrowth in childhood, and impaired intellectual development. We herein report the successful orthodontic treatment of a 14-year-old boy with Sotos syndrome caused by a heterozygous mutation in the NSD1 gene. He showed severe hypodontia, impaction of the maxillary second molars and a skeletal Class III jaw-base relationship. Orthodontic management, including space control by protraction of the maxillary first molars and traction of the impacted molars, was performed using fixed appliances and miniscrews. As a result, acceptable occlusion was obtained without any discernible relapse 18 months postretention.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"164-172"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Levator Veli Palatini: Are all Segments Created Equal?","authors":"Jamie L Perry, Taylor D Snodgrass, Imani R Gilbert, Jessica L Williams, Davinder J Singh, Thomas J Sitzman","doi":"10.1177/10556656241271666","DOIUrl":"10.1177/10556656241271666","url":null,"abstract":"<p><strong>Introduction: </strong>The levator veli palatini (LVP) muscle has two segments with distinct roles in velopharyngeal function. Previous research suggests longer extravelar segments with shorter intravelar segments may lead to a more advantageous mechanism for velopharyngeal closure. The purpose of this study was to examine whether the distribution of the LVP intravelar and extravelar segments differs between children with cleft palate with and without VPI and controls.</p><p><strong>Methods: </strong>The study included 97 children: 37 with cleft palate +/- lip with VPI, 37 controls, and 19 with cleft palate with normal resonance. Measures included mean LVP length, mean extravelar LVP length, and intravelar LVP length.</p><p><strong>Results: </strong>Overall mean LVP length was similar (<i>P</i> = .267) between controls and children with cleft palate (with and without VPI). However, there was a significant difference (<i>P </i>< .001) between group for both intravelar and extravelar LVP lengths: the intravelar segment was significantly longer in those with VPI compared to controls and children with cleft palate and normal resonance; and the extravelar segment was significantly shorter in those with VPI compared to controls and children with cleft palate and normal resonance.</p><p><strong>Conclusions: </strong>Results from this study demonstrate a significant difference between the distribution of the functional segments of the LVP among children with VPI, with a more disadvantageous distribution of the muscle segments among those with VPI.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"28-34"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of Videorecorded Speech Samples for Children with Cleft Palate: Methods to Facilitate High-Quality Speech Outcomes Data Collection.","authors":"Adriane L Baylis, Caitlin E Cummings, Kari M Lien, Thomas J Sitzman, Richard E Kirschner, Kathy L Chapman","doi":"10.1177/10556656231217645","DOIUrl":"10.1177/10556656231217645","url":null,"abstract":"<p><strong>Background: </strong>Collection of high-quality videorecorded speech samples is essential for speech outcomes research.</p><p><strong>Solution: </strong>Cleft palate team SLPs were trained to collect standard videorecorded speech samples in the clinic setting across 20 sites in North America. Standard training and equipment was provided.</p><p><strong>What we did that is new: </strong>Quality management procedures were developed and utilized to verify video quality and protocol adherence. Over 97% of speech samples collected by trained SLPs met defined quality standards.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"2090-2096"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an Artificial Intelligence-Based Algorithm for the Assessment of Skeletal Age and Detection of Cervical Vertebral Anomalies in Patients with Cleft Lip and Palate.","authors":"Gaithoiliu Kamei, Puneet Batra, Ashish Kumar Singh, Garima Arora, Simran Kaushik","doi":"10.1177/10556656241299890","DOIUrl":"https://doi.org/10.1177/10556656241299890","url":null,"abstract":"<p><p>To develop an artificial intelligence (AI)-based algorithm for the assessment and comparison of skeletal maturation in patients with and without cleft lip and/or palate and to detect the presence of cervical vertebral anomalies (CVAs).</p><p><p>Retrospective cohort study.</p><p><p>A university orthodontic clinic and comprehensive cleft care centers.</p><p><p>In total, 1080 cephalograms of patients with and without unilateral cleft lip and palate (UCLP) aged 6 to 18 years, without any associated syndromes, congenital disorders, or history of trauma or illness, were collected. About 960 cephalograms were assessed in the study upon elimination of poor-quality lateral cephalograms.</p><p><p>The MobileNet architecture using TensorFlow framework was employed to develop 2 convolutional neural network (CNN)-based AI models for automated assessment of skeletal age and detection of CVAs. Inter-rater reliability for manual cervical vertebral maturation (CVM) staging was assessed using Cohen's kappa coefficient, and intraclass correlation coefficient (ICC) was calculated. The results of each model were separately analyzed using chi-square test, and the statistical significance was tested at 5% level.</p><p><p>The CNN-based AI model yielded an average accuracy rate of 74.5%, with an accuracy of up to 88% for detecting skeletal maturity and an accuracy rate of 83% for detecting CVAs.</p><p><p>It can be concluded that CVM methods help detect skeletal maturity objectively in patients with UCLP and have shown delayed skeletal growth compared to patients without UCLP. CVAs were found to be more prevalent in patients with UCLP than in their non-cleft counterparts, with these findings facilitated by utilizing a novel AI algorithm.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241299890"},"PeriodicalIF":1.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}