Cleft Palate-Craniofacial Journal最新文献

{"title":"Prenatal Diagnosis of Nonsyndromic Craniosynostosis: A Scoping Review.","authors":"Gwendolyn E Daly, Alexa Stefanko, Catherine Henning, Lisa Crupi, Lori K Howell, Erik M Wolfswinkel","doi":"10.1177/10556656241308352","DOIUrl":"https://doi.org/10.1177/10556656241308352","url":null,"abstract":"<p><p>Craniosynostosis is rarely diagnosed in utero. Prenatal diagnosis has the potential to improve patient outcomes and streamline care, however, and is becoming more feasible as technology improves. The objective of this study is to examine existing literature on prenatal diagnosis of nonsyndromic craniosynostosis.</p><p><p>In accordance with PRISMA guidelines, Embase, Cochrane, and PubMed were searched for articles discussing prenatal diagnosis of nonsyndromic craniosynostosis via imaging studies. Studies that exclusively examined syndromic craniosynostosis were excluded.</p><p><p>Diagnostic criteria for prenatal diagnosis of craniosynostosis.</p><p><p>The search identified 2129 articles. And 12 articles met inclusion criteria and were included in the final analysis. Ten of 12 included studies (83.3%) utilized biometric data (biparietal and occipitofrontal diameter, cranial index) to analyze fetal head shape. Two of 12 studies (16.7%) utilized specific ultrasonic markers to identify craniosynostosis including a \"brain shadowing sign.\" One study (8.3%) created a systematic quantitative screening methodology with formal shape analysis for identification of sagittal synostosis. In all included studies, identification of craniosynostosis was possible in the second or third trimesters.</p><p><p>Prenatal diagnosis of craniosynostosis is feasible and has the potential to improve patient outcomes. Creation of screening protocols and standardized metrics for sonographic diagnosis are important next steps in craniosynostosis care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241308352"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957658","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":"Multidisciplinary Oral Rehabilitation of Complex Frontonasal Dysplasia: A Case Report.","authors":"Roberta Costa E Silva, Cristiano Tonello, José Carlos da Cunha Bastos, Regina Magrini Guedes de Azevedo, Roseli Maria Zechi-Ceide, Daniela Garib, Felicia Miranda, Beatriz Martins de Andrade, José Fernando Castanha Henriques, Adriano Porto Peixoto","doi":"10.1177/10556656241307738","DOIUrl":"10.1177/10556656241307738","url":null,"abstract":"<p><p>This case report presents the multidisciplinary treatment of a male patient with a complex form of frontonasal dysplasia who presented with a 0 to 14 facial cleft, mild hypertelorism, absence of the nasal medial process of the nose, and frontonasal encephalocele. Cranial and plastic surgeries were performed to correct hypertelorism and improve the esthetic appearance of the frontonasal region. In the permanent dentition, the patient presented a Class II, division 1 malocclusion with severe maxillary constriction and bilateral posterior crossbite. Comprehensive orthodontic treatment started at 12 years of age and included rapid maxillary expansion followed by fixed appliance. Orthognathic surgery was performed at 21 years of age involving a forward movement of both maxilla and mandible. After debonding, veneers were made in maxillary anterior teeth to improve tooth shape and Bolton discrepancies. An improvement in facial esthetics and an adequate final occlusion were achieved. Multidisciplinary treatment was essential for morphological rehabilitation and social inclusion in patients with rare craniofacial anomalies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241307738"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957656","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":"Primary Rhinoplasty for Unilateral Cleft Lip: A Long-Term Cohort Assessment of Aesthetic and Anthropometric Outcomes.","authors":"Jinggang J Ng, Manisha Banala, Jonathan H Sussman, Benjamin B Massenburg, Meagan Wu, Dominic J Romeo, Oksana A Jackson, David W Low, Jesse A Taylor, Jordan W Swanson","doi":"10.1177/10556656241309810","DOIUrl":"https://doi.org/10.1177/10556656241309810","url":null,"abstract":"<p><p>The decision to undertake rhinoplasty maneuvers during cleft lip repair remains controversial. Little data compare long-term outcomes with and without primary rhinoplasty (PR). This study compared nasolabial outcomes in cohorts with unilateral cleft lip (UCL) treated with and without PR at the Children's Hospital of Philadelphia using standardized aesthetic and anthropometric assessments.</p><p><p>Retrospective cohort study.</p><p><p>Tertiary care pediatric hospital.</p><p><p>Patients who underwent lip repair for UCL.</p><p><p>Cleft lip repair with and without PR.</p><p><p>Anthropometric analyses and crowdsourced aesthetic assessments using Americleft nasolabial appearance reference scales and pairwise comparisons.</p><p><p>Among 208 patients, 155 (74.5%) and 53 (25.5%) underwent lip repair with and without PR at 4.5 ± 1.1 months. Primary rhinoplasty (β = 0.345, <i>P</i> = .037) and a lower Cleft Lip Severity Index (β = -0.341, <i>P</i> < .001) predicted superior pairwise rank at 4.9 ± 1.9 years of age. History of PR predicted decreased columellar deviation angle (CDA) (β = -2.375, <i>P</i> = .019) and improved nostril symmetry (β = 0.111, <i>P</i> = .038). Increased columellar-labial angle (<i>r</i> = 0.27, <i>P</i> = .002), improved nostril symmetry (<i>r</i> = -0.23, <i>P</i> = .01), and decreased CDA (<i>r</i> = -0.45, <i>P</i> < .001) correlated with superior ratings. Patients with ˂20 days of postoperative nasal stenting had inferior lateral ratings (2.4 ± 0.6 vs 2.1 ± 0.5, <i>P</i> = .005). Those who underwent surgery at ˂5.3 months had inferior nasal projection (Goode's ratio 0.56 ± 0.09 vs 0.62 ± 0.08, <i>P</i> = .006).</p><p><p>Primary rhinoplasty for UCL offers superior aesthetic results in early childhood by layperson and anthropometric assessments. Specific improved characteristics from PR-CDA and nostril symmetry-most greatly influence layperson perception of nasal appearance. Older age at surgery predicted increased nasal projection, while prolonged nasal stenting predicted superior profile appearance.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241309810"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957674","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":"Unveiling Oral Health Differences: Gingival Health and Hygiene in Children With and Without Cleft Lip and Palate.","authors":"Guida Paola Genovez, Matheus Souza de Campos Costa, Lucas José de Azevedo-Silva, Gisele da Silva Dalben, Daniela Gamba Garib, Ana Lúcia Pompéia Fraga de Almeida","doi":"10.1177/10556656241310098","DOIUrl":"https://doi.org/10.1177/10556656241310098","url":null,"abstract":"<p><strong>Objective: </strong>To compare the oral hygiene and gingival health of children with and without cleft lip and palate.</p><p><strong>Design: </strong>Cross-sectional comparative study.</p><p><strong>Setting: </strong>Institutional tertiary referral hospital.</p><p><strong>Patients/participants: </strong>This study was conducted on 108 children aged 6 to 12 years, divided into 3 groups: Group 1 = children with cleft lip and alveolus with or without cleft palate, unilateral or bilateral (<i>n</i> = 36, 22 boys and 14 girls, aged 8, 39 ± 1.61 years), Group 2 = children with isolated cleft palate (<i>n</i> = 36, 8 boys and 28 girls, 8.11 ± 1.88 years); and Group 3 = children without clefts (<i>n</i> = 36, 18 boys and 18 girls, 8.53 ± 1.33 years).</p><p><strong>Main outcome measures: </strong>The clinical parameters evaluated were Gingival Index (GI) and Patient Hygiene Performance (PHP) Index. analysis of variance and Kruskal-Wallis tests were used to evaluate intergroup differences. Correlations between the variables age, PHP Index and GI were assessed by the Spearman correlation (<i>P</i> < .05).</p><p><strong>Results: </strong>The results demonstrated no statistically significant difference between the three groups for the PHP index (<i>P</i> = .126). There was also no intergroup difference for GI (<i>P</i> = .418).</p><p><strong>Conclusions: </strong>No difference for the gingival status was observed between children with cleft lip and palate and with isolated cleft palate. Children with oral clefts present adequate gingival status compared to noncleft children.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241310098"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957678","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":"Evaluation of the Effect of Unilateral Cleft Palate on Piriform Aperture Dimensions.","authors":"Emre Aytuğar, Fahrettin Kalabalık, Emre Haylaz, Muhammed Şamil Özkan, Burçin Akan","doi":"10.1177/10556656241311056","DOIUrl":"https://doi.org/10.1177/10556656241311056","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present research was to assess and compare the piriform aperture dimensions of subjects with a unilateral cleft lip and palate (UCLP) and those of a control group using cone-beam computed tomography (CBCT).</p><p><strong>Design: </strong>CBCT data of 40 subjects with a complete UCLP (28 males and 12 females, with a mean age of 17.21 ± 5.75 years) and 40 CBCT images of age- and <i>sex-matched</i> subjects with no cleft, serving as the control group (28 males, 12 females; mean age, 17.25 ± 5.74 years) were included in the study. The maximal height and width of the piriform aperture as well as nasal bone height were measured and statistically compared between the groups.</p><p><strong>Results: </strong>There were no significant differences in the age and sex distributions between the groups. The mean piriform aperture height was significantly lower in the UCLP group than in the control group, while the mean piriform aperture width was significantly higher in the UCLP group compared to the control group (<i>P</i> < .01). Furthermore, the mean bony nasal height was found to be significantly lower in the UCLP group than in the control group (<i>P</i> < .01).</p><p><strong>Conclusions: </strong>According to the present findings, UCLP is associated with changes in the piriform aperture dimensions due to lower height and higher width values. These structural alterations may contribute to the functional and aesthetic nasal challenges in patients with UCLP.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241311056"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957599","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":"Evaluating the Use of a 3D Exoscope to Improve Ergonomics in Cleft Surgery.","authors":"Kwang Chear Lee, Benjamin Frearson, Bashirat Adedoyin Alagbe, Mohamed Gamal Abdelazim Salem ElSafti, Craig Nightingale, Jane Cooke, Channa Panagamuwa, Kezia Echlin, Khurram Khan","doi":"10.1177/10556656241305229","DOIUrl":"https://doi.org/10.1177/10556656241305229","url":null,"abstract":"<p><p>The aim of this study was to investigate and compare the technical feasibility, ergonomics, and educational value of the 3D exoscope in comparison with traditional and prism loupes in cleft surgery.</p><p><p>A variety of cleft and pharyngeal operations were performed with the VITOM^® 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany), traditional/prism loupes, and microscope. The cervical neck angulation of the operating surgeon was recorded in real-time with an inertia measurement unit system (Mbient, San Francisco, USA) and experiences of the surgeon and assistant were prospectively evaluated with 5-point Likert scales.</p><p><p>National Health Service, England.</p><p><p>Eleven patients were recruited in whom 12 procedures were performed. Two main surgeons, 3 assistant surgeons, and 3 scrub nurses were recruited into the study.</p><p><p>Four procedures were performed with the VITOM^® 3D exoscope, and as the comparison groups, 5 procedures were performed with normal loupes, 3 with prism loupes, and 2 were done in combination with a microscope and analyzed separately.</p><p><p>Neck angle measurements and feedback from surgeons, assistants, and scrub nurses.</p><p><p>The VITOM^® system improved surgeon ergonomics with reduced procedure time in cervical flexion when compared to the other visualization methods (versus loupes, <i>P</i> < .01, and prism, <i>P</i> < .01). The VITOM^® system also scored favorably in terms of image-related fields, ergonomics, and ease of use.</p><p><p>Use of the 3D exoscope in cleft surgery yielded improved experiences for both surgeons, assistants, and nurses in comparison with loupes and microscopes without increasing operating time.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241305229"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957597","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":"Identifying Components of an Enhanced Recovery Pathway for Primary Cleft Palate Repair: A Scoping Review.","authors":"Richard Gaule, Jonathan Jeger, Solmaz Nakhjavani, Yvonne Doyle, Muireann Ryan, Jane Gunn, Catherine de Blacam","doi":"10.1177/10556656241298428","DOIUrl":"https://doi.org/10.1177/10556656241298428","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to map the existing sources of evidence on perioperative care and recovery strategies for primary cleft palate repair, to identify elements that should be included in an enhanced recovery pathway (ERP), and to identify gaps in current knowledge.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Setting: </strong>ERPs are evidence-based, patient-centered, multimodal, perioperative care pathways designed to reduce surgical stress and improve postoperative outcomes and are increasingly being reported in the cleft lip and palate literature.</p><p><strong>Interventions: </strong>PubMed, Embase, Cochrane, and Scopus databases were searched. Results were uploaded to Covidence systematic review software. Studies were included for analysis if they described strategies or elements for enhanced recovery following primary cleft palate repair.</p><p><strong>Main outcome measures: </strong>ERP elements and outcome measures were recorded and collated.</p><p><strong>Results: </strong>Forty-seven studies were included. Frequently reported topics included anesthesia, peri-operative analgesia, and parent education. There was a dearth of evidence about peri-operative nursing care. Based on the extracted data, we propose that the following elements be included in any ERP for primary cleft palate repair: preoperative parent/caregiver education; minimization of preoperative fasting time; preoperative analgesia; local anesthetic nerve blocks; perioperative antibiotics and ondansetron; postoperative non-opioid analgesia; early postoperative oral feeding and discharge planning.</p><p><strong>Conclusions: </strong>The findings provide the framework to develop an institutional ERP for primary cleft palate repair. The positive contribution of consistent nursing care to enhanced recovery is obvious but under-investigated in the literature to date. The impact of ERPs on parent-reported outcomes also warrants further investigation.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241298428"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957601","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":"Effect of Probiotic Toothpaste on Enamel Mineralization and <i>Streptococcus mutans</i> Levels in Cleft Orthodontic Patients-A Randomized Clinical Trial.","authors":"Dinesh Murugesan, C Siva Subramanian, Vignesh Kailasam","doi":"10.1177/10556656241309444","DOIUrl":"https://doi.org/10.1177/10556656241309444","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of probiotic and fluoride toothpaste on enamel mineralization and <i>Streptococcus mutans</i> levels in cleft lip and/or palate patients undergoing fixed orthodontic appliance therapy.</p><p><strong>Design: </strong>A randomized comparative trial with a 1:1 allocation ratio.</p><p><strong>Participants: </strong>Thirty-two patients with cleft lip and/or palate undergoing fixed orthodontic appliances were recruited.</p><p><strong>Interventions: </strong>Cleft lip and/or palate patients undergoing fixed orthodontic appliances were randomized into Group 1 (probiotic toothpaste) or Group 2 (fluoride toothpaste). The toothpaste was given to the patient after oral prophylaxis. The patients were advised to use the toothpaste two times a day (morning and night) for a period of 4 weeks.</p><p><strong>Main outcomes: </strong>Enamel mineral content was assessed before intervention (T0) and after 4 weeks of intervention (T1) using DIAGNOdent. <i>Streptococcus mutans</i> levels were assessed after 4 weeks of intervention (T1) for both the groups using real time-polymerization chain reaction (RT-PCR). Paired <i>t</i>-tests and <i>t</i>-tests were used for intragroup and intergroup comparisons, respectively. A <i>P</i>-value < .05 was considered statistically significant.</p><p><strong>Results: </strong>Both the groups showed improvement in enamel mineral content after 4 weeks of intervention. <i>Streptococcus mutans</i> levels in the probiotic-containing toothpaste were lesser when compared to the fluoridated toothpaste group. No statistically significant difference was found between probiotic toothpaste and fluoridated toothpaste in both the assessed parameters.</p><p><strong>Conclusions: </strong>Probiotic toothpaste is as effective as fluoride toothpaste in enamel remineralization. Probiotic toothpaste showed greater inhibitory effect on <i>Streptococcus mutans</i> than the fluoridated toothpaste.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241309444"},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957586","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":"Use of Local Anesthesia in Adolescent and Adults Undergoing Cleft Lip Repair or Revision: A Systematic Review.","authors":"Amer Mansour, Wassim Najjar, Jose A Garcia-Garcia, Beyhan Annan, Raj M Vyas, Usama S Hamdan","doi":"10.1177/10556656241311069","DOIUrl":"10.1177/10556656241311069","url":null,"abstract":"<p><p>ObjectiveThis study aims to assess the safety and efficacy of solely using local anesthetics for cleft lip repair and/or revision in adolescent and adult patients.DesignSystematic review.SettingClinical studies describing the use of local anesthetics in cleft lip repair procedures.Patients, ParticipantsA literature search was conducted using PubMed, Google Scholar, and Embase following the PRISMA 2020 guidelines. Inclusion criteria were studies focusing exclusively on local anesthetic techniques in adolescent or adult patients undergoing cleft lip procedures. Non-English studies, studies involving patients under the age of 10, or those undergoing cleft palate or other otolaryngological procedures were excluded. Risk of bias was addressed by using a modified Downs and Black checklist.InterventionsReview of local anesthetic use alone for adult and adolescent patients undergoing cleft lip repair or revision.Main OutcomesThe main studied outcomes were any reported general perioperative complications, the necessity of switching to general anesthesia, patients' self-reported pain during the surgery, wound dehiscence, wound infection, and the need for postoperative narcotics for pain control.ResultsThe included studies demonstrated consistent evidence supporting the sole use of local anesthesia for cleft lip repair and revision, with absence of wound dehiscence or infection. Most patients reported minimal to no pain and required no general anesthesia during the procedures.ConclusionsThe current literature supports the safety and efficacy of local anesthesia alone for cleft lip repair and revision procedures. This modality offers a promising approach in resource-limited countries where access to general anesthesia is often limited.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241311069"},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957690","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":"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}