Cleft Palate-Craniofacial Journal最新文献

{"title":"Crowdsourcing the Impact of Illustration in Cleft Surgery Education.","authors":"Meagan Wu, Elizabeth B Card, Jonathan H Sussman, Dillan F Villavisanis, Benjamin B Massenburg, Jinggang J Ng, Dominic J Romeo, Jordan W Swanson, Jesse A Taylor, David W Low","doi":"10.1177/10556656241257101","DOIUrl":"https://doi.org/10.1177/10556656241257101","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to (1) assess layperson preferences for how surgical information is presented; (2) evaluate how the format of visual information relates to layperson comfort with undergoing surgery, perceptions of surgeon character traits, and beliefs about artistic skill impacting plastic surgery practice; and (3) identify sociodemographic characteristics associated with these outcomes.</p><p><strong>Design: </strong>A survey was developed in which one of five standardized sets of information depicting a unilateral cleft lip repair was presented as (1) text alone, (2) quick sketches, (3) simple drawings, (4) detailed illustrations, or (5) photographs.</p><p><strong>Setting: </strong>Online crowdsourcing platform.</p><p><strong>Participants: </strong>Raters aged 18 years and older from the United States.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measure(s): </strong>After viewing the surgical information, participants answered three sets of Likert scale questions. Ratings were averaged to produce three composite scores assessing (1) comfort with undergoing surgery (2) perceptions of surgeon character traits, and (3) beliefs about plastic surgery and artistry.</p><p><strong>Results: </strong>Four hundred seventy-nine participants were included. Surgeon character traits score was highest among participants who viewed detailed illustrations at 4.46 ± 0.59, followed by photographs at 4.43 ± 0.54, text alone at 4.28 ± 0.59, simple drawings at 4.17 ± 0.67, and quick sketches at 4.17 ± 0.71 (<i>p </i>= 0.0014). Participants who viewed detailed illustrations rated surgical comfort score and plastic surgery and artistry score highest, although differences did not achieve statistical significance.</p><p><strong>Conclusions: </strong>Viewing detailed cleft lip repair illustrations was significantly associated with positive perceptions of surgeon character traits. Our data help to contextualize methods of communication and education valued by the public when seeking cleft care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082738","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":"Gingivoperiosteoplasty in Children with Cleft Lip and Palate: The Need for Alveolar Bone Grafting.","authors":"Darius Balumuka, Gwendolyn E Daly, Kelsi Krakauer, Samantha Burch, Breanna Jedrzejewski, Alicia Johnson, Lori K Howell, Erik M Wolfswinkel","doi":"10.1177/10556656241256917","DOIUrl":"https://doi.org/10.1177/10556656241256917","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the efficacy of gingivoperiosteoplasty (GPP) in preventing alveolar bone grafting (ABG) among children with cleft lip and palate (CLP).</p><p><strong>Design/setting: </strong>Retrospective university hospital single center study.</p><p><strong>Patients: </strong>Children with CLP treated with GPP from 2000-2015 were included. Those under eight years of age, without definitive conclusions regarding need for ABG or with incomplete data were excluded.</p><p><strong>Interventions: </strong>Included patients were analyzed for demographics, cleft type, age at GPP, associated cleft surgery, use of nasoalveolar molding (NAM), indication for ABG, operating surgeon and presence of residual alveolar fistula. T-tests and Fisher's exact tests were utilized for statistical analysis.</p><p><strong>Main outcome measure: </strong>The need for ABG.</p><p><strong>Results: </strong>Of the 1682 children identified with CLP, 64 underwent GPP and met inclusion criteria. 78% of patients with CLP who underwent GPP were recommended for ABG. Those who received GPP at a younger age (<i>P</i> = .004) and at the time of initial cleft lip repair (<i>P</i> = .022) were less likely to be recommended for ABG. Patients with complete CLP were more likely to be recommended for ABG than patients with cleft lip and alveolus only (<i>P</i> = .015). The operating surgeon impacted the likelihood of ABG (<i>P</i> = .004). Patient gender, race, ethnicity, laterality, and NAM were not significantly associated with recommendation for ABG.</p><p><strong>Conclusion: </strong>GPP does not preclude the need for ABG. Therefore, the success of ABG after GPP and maxillary growth restriction should be analyzed further to determine if GPP is a worthwhile adjunct to ABG in cleft care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082742","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":"Travel Distance and Spanish-Speaking are Associated with Delays in the Treatment of Cleft Palate.","authors":"Eloise W Stanton, Danielle Rochlin, H Peter Lorenz, Clifford C Sheckter","doi":"10.1177/10556656241256923","DOIUrl":"10.1177/10556656241256923","url":null,"abstract":"<p><strong>Objective: </strong>Delayed repair of cleft palate is associated with worse speech outcomes. Social determinants of health may influence the timing of surgery; however, there are no population health investigations to evaluate factors such as travel distance, language barriers, and payer. This study sought to identify factors that may interfere with timely cleft palate repair.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>National/multi-center.</p><p><strong>Patients/participants: </strong>All cleft palate repairs within California were extracted from 2000-2021.</p><p><strong>Main outcomes measures: </strong>The primary outcome was age at surgical repair, which was modeled with linear regression. Covariates included race, primary language, distance from patient home to hospital, socioeconomic status, primary payer, and managed care enrollment status.</p><p><strong>Results: </strong>11 260 patients underwent surgical repair of a cleft palate. Black race was associated with delayed repair (22 additional days, <i>P</i> = .004, 95% CI 67.00-37.7) along with Asian/Pacific-Islander race (11 additional days, <i>P</i> = .006, 95% CI 3.26-18.9) compared to white race. Spanish-speaking patients had significantly later cleft palate repairs by 19 days, (<i>P</i> < .001, 95% CI 10.8-27.7) compared with English-speaking. Further distances from the hospital were significantly associated with later cleft surgeries with out-of-state patients undergoing surgery 52 days later (<i>P</i> < .001, 95% CI 11.3-24.3). Managed care plans and Medi-Cal were significantly associated with earlier surgical repair compared with private insurance.</p><p><strong>Conclusion: </strong>Black, Asian Pacific Islander, and Spanish-speaking patients and greater distance traveled to hospital were associated with delayed cleft palate repairs. These results underscore the importance of addressing structural and social barriers to care to improve outcomes and reduce health disparities for patients with cleft palate.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077071","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":"Comparison of Facial Aesthetic Evaluation Given by Patients with Cleft Lip and/or Palate and Professionals: A Systematic Review.","authors":"Xin Wang, Wenying Kuang, Jianan Yan, Jingyi Xu, Xinyu Zhang, Yanping Jiang, Wenjun Yuan","doi":"10.1177/10556656241254186","DOIUrl":"https://doi.org/10.1177/10556656241254186","url":null,"abstract":"<p><strong>Objective: </strong>To compare the differences of facial aesthetic evaluation between patients with Cleft Lip and/or Palate (CL/P) and professionals for the treatment outcome of CL/P.</p><p><strong>Design: </strong>This systematic review was conducted on MedLine, Web of Science, Embase and Cochrane Library databases. The Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool was used to evaluate the included researches.</p><p><strong>Setting: </strong>Not applicable.</p><p><strong>Patients, participants: </strong>Patients with CL/P and professionals.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The facial aesthetic evaluation of patients with CL/P and professionals.</p><p><strong>Results: </strong>Among the 1695 literatures retrieved, 22 articles were included, including 974 patients with CL/P and 251 professionals. The bias risk assessment on 21 articles was rated \"Moderate\" and only one article was rated \"Serious\". Due to the high heterogeneity of the included studies, meta-analysis was not possible, so descriptive analysis was conducted. Among the included studies, two articles indicated similar views from both groups, 19 noted differences between the two groups, of which three articles indicated more positive evaluation by professionals and nine articles indicated more positive evaluation by patients.</p><p><strong>Conclusions: </strong>The available data indicate that there is a difference between patients with CL/P and professionals in the aesthetic evaluation, but it is not clear which group is more positive. During the treatment of patients with CL/P, apart from the objective aesthetic evaluation, professionals should fully consider subjective ideas and self-assessment of patients, in order to improve the quality of life for patients.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944490","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":"Analysis and Reporting of Randomized Trials in Cleft Palate Surgery: Learning from the Timing of Primary Surgery (TOPS) Trial.","authors":"Matthew Fell, Ginette Phippen, Stephanie van Eeden, David Chong, Marc C Swan, Simon van Eeden, John B Carlin","doi":"10.1177/10556656241253949","DOIUrl":"https://doi.org/10.1177/10556656241253949","url":null,"abstract":"<p><p>The Timing of Primary Surgery (TOPS) trial was published August 2023 in the New England Journal of Medicine and is a milestone achievement for a study focused on cleft palate. Due to the complexity of outcome reporting in cleft and the rarity of such comparative trials, TOPS presents a useful opportunity to critically review the design, analysis and reporting strategies utilised. This perspective article focused on the inclusion of participants, the choice of the primary outcome measure and the analysis of ordinal data within the trial. Considerations for future comparative studies in cleft care are discussed.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899962","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":"Identification of a Novel TP63 Variant in a Chinese Patient with Orofacial Clefts and Ectrodactyly: Case Report and Literature Review.","authors":"Leheng Jiang, Chanyuan Jiang, Tao Song, Yongqian Wang, Nuo Si, Haidong Li, Ningbei Yin","doi":"10.1177/10556656241241132","DOIUrl":"https://doi.org/10.1177/10556656241241132","url":null,"abstract":"<p><p>The TP63 gene is essential for epithelial proliferation, differentiation, and maintenance during embryogenesis. Despite considerable clinical variability, <i>TP63</i>-related symptoms are characterized by ectodermal dysplasia, distal limb malformations, and orofacial clefts. We identified a novel <i>TP63</i> variant (c.619A > G, p.K207E) in a seven-month-old Chinese patient with orofacial clefts and ectrodactyly but no evident signs of ectodermal dysplasia. This phenotype was rarely reported before. We summarized the presence of the three main <i>TP63</i>-related manifestations in the literature and noted different distributions of CP- and CL/P-related variants regarding p63 structural domains.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892596","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":"Treatment Outcomes of Lip Taping in Patients with Non-syndromic Cleft Lip and/or Palate: A Systematic Review and Meta-analysis.","authors":"Vignesh R, Ruchi Singhal, Ritu Namdev, Adarsh Kumar, Charu Dayma, Asha Rani","doi":"10.1177/10556656241249822","DOIUrl":"10.1177/10556656241249822","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a systematic review of the data in peer-reviewed medical literature and evaluate the effectiveness of lip taping as a pre-surgical naso-alveolar molding (NAM) technique in infants with cleft lip and/or palate.</p><p><strong>Design: </strong>An electronic search of various databases for relevant studies, regardless of date, from inception to June 2023 was carried out and evaluated. After completing the electronic search and applying our inclusion/exclusion criteria, 6 studies-2 randomized control trials, 2 non-randomized studies, and 2 case series-were included. Data extraction of relevant articles was done independently by 2 authors. Quality assessment was done using the JBI prevalence critical appraisal tool and certainty of evidence was carried out by GRADE approach.</p><p><strong>Main outcome measures: </strong>Nasolabial Aesthetics, Dentoalveolar Relationship.</p><p><strong>Results: </strong>A total of six studies were included in the current review. Meta-analysis was carried out, and forest plots were obtained for a single mean from the lip-taping group. 3 studies had a low risk of bias, while 3 studies displayed a serious risk of bias. Significant improvement in various outcome measures was noted with lip taping when compared with the control group although the certainty of evidence was very low.</p><p><strong>Conclusion: </strong>When compared to no therapy, lip taping appears to ameliorate dentoalveolar measurements and nasolabial aesthetics. To increase our knowledge of lip taping, more research will be needed in the future, as there are not many studies to prove lip taping is better than other treatment approaches.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873362","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":"Same-day Discharge for Cleft Palate Repair: A Single-Surgeon Retrospective Analysis.","authors":"Allison L Diaz, Leya Groysman, Liliana Camison, Roberto L Flores, David A Staffenberg","doi":"10.1177/10556656241251932","DOIUrl":"https://doi.org/10.1177/10556656241251932","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety of same-day discharge for patients undergoing primary cleft palate repair.</p><p><strong>Design: </strong>Single-surgeon retrospective review.</p><p><strong>Setting: </strong>Tertiary care institution.</p><p><strong>Patients/participants: </strong>40 consecutive patients that underwent primary cleft palate repair by a single surgeon from September 2018 to June 2023.</p><p><strong>Interventions: </strong>Same-day discharge versus overnight admission after primary palatoplasty.</p><p><strong>Main outcome measures: </strong>30-day readmission, reoperation, wound and all-cause complication rate and 1-year fistula incidence.</p><p><strong>Results: </strong>Of 40 total cases, 20 patients were discharged on the same calendar day and 20 patients were admitted for overnight stay following primary cleft palate repair. In the same-day discharge group, readmission incidence was 10%(n = 2), wound complication incidence was 5%(n = 1), and postoperative complication incidence was 15%(n = 3). In comparison, patients admitted overnight had a readmission incidence of 5%(n = 1, <i>P</i> = 1.00), wound complication incidence of 10%(n = 2, <i>P</i> = 1.00), and postoperative complications of 20%(n = 4, <i>P</i> = 1.00) No patients had 30-day reoperations or fistulas at 1 year. A higher proportion of admitted patients held a preoperative diagnosis of unilateral cleft palate and alveolus (Veau 3) as compared to patients discharged on the same day (<i>P</i> = .019). During the postoperative hospital course, admitted patients received significantly more oxycodone at median of 2 doses (IQR 1.00-3.75) and acetaminophen at a median of 4 doses (IQR 3.00-5.00) than patients with same-day discharge with a median of 1 dose (IQR 0.00 -1.00, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>In a low-risk patient population, same-day discharge following primary cleft palate repair may be safely undertaken and result in similar short-term outcomes and 1-year fistula incidence as patients admitted for overnight stay.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877788","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":"Novel Technique for Median Cleft Lip Comprising the Simultaneous Formation of the Columella, Philtrum, and Cupid's Bow.","authors":"Hikaru Fujito, Naritaka Kimura, Hikaru Moriyama, Syouta Matsuda, Hiroya Mihara","doi":"10.1177/10556656241253411","DOIUrl":"https://doi.org/10.1177/10556656241253411","url":null,"abstract":"<p><p>Numerous surgical techniques for median cleft lip repair have been described; however, most cause excessively sharp peaks or the collapse of Cupid's bow. We report a technique for median cleft lip repair using a mucosal skin flap and full-thickness skin graft and 15 years of follow-up. Our technique provides acceptable formation of the columella, philtrum, and the two peaks of Cupid's bow. In this paper, we cite our previously reported techniques and add new findings and discussion based on the long-term postoperative outcomes of this procedure. Advantages and disadvantages of this technique are discussed, and a possible solution to achieve a more satisfactory result is suggested. Advantages and disadvantages of this new technique are discussed, and a possible solution to achieve a more satisfactory result is suggested.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858758","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":"Cleft Summit 2022: The Impact of a Unified Voice.","authors":"Raj M Vyas, Wassim Najjar, Joseph E Losee, Ann W Kummer, Usama S Hamdan","doi":"10.1177/10556656241242699","DOIUrl":"https://doi.org/10.1177/10556656241242699","url":null,"abstract":"<p><strong>Objective: </strong>The inaugural Cleft Summit aimed to unite experts and foster interdisciplinary collaboration, seeking a collective understanding of velopharyngeal insufficiency (VPI) management.</p><p><strong>Design: </strong>An interactive debate and conversation between a multidisciplinary cleft care team on VPI management.</p><p><strong>Setting: </strong>A two-hour discussion within a four-day comprehensive cleft care workshop (CCCW).</p><p><strong>Participants: </strong>Thirty-two global leaders from various cleft disciplines.</p><p><strong>Interventions: </strong>Cleft Summit that allows for meaningful interdisciplinary collaboration and knowledge exchange.</p><p><strong>Main outcome measures: </strong>Ability to reach consensus on a unified statement for VPI management.</p><p><strong>Results: </strong>Participants agreed that a patient with significant VPI and a dynamic velum should first receive a surgery that lengthens the velum to optimize patient outcome. A global, multicenter prospective study should be done to test this hypothesis.</p><p><strong>Conclusion: </strong>The 1st Cleft Summit successfully distilled global expertise into actionable best-practice guidelines through iterative discussions, fostering interdisciplinary collaboration and paving the way for a transformative multi-center prospective study on VPI care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860603","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}