Cleft Palate-Craniofacial Journal最新文献

{"title":"Hospital Charges and Perioperative Outcomes of Spring-Assisted Cranioplasty vs Open Cranial Vault Remodeling for Sagittal Synostosis.","authors":"Samantha D Morin, Adam B Fleming, Ronald R McCall, Kendall C Pitre, Henry H Taylor, Colton Fernstrum, Laura S Humphries, Ian C Hoppe","doi":"10.1177/10556656251411365","DOIUrl":"10.1177/10556656251411365","url":null,"abstract":"<p><p>ObjectiveTo evaluate and compare perioperative outcomes and hospital charges between spring-assisted cranioplasty (SAC) and open cranial vault remodeling (OCVR) for single-suture craniosynostosis, with primary analysis focused on sagittal synostosis.DesignRetrospective cost analysis.SettingSingle tertiary academic center.Patients, ParticipantsPatients diagnosed with single-suture craniosynostosis who underwent surgical repair between 2012 and 2024.InterventionsSurgical repair via SAC or OCVR.Main Outcome Measure(s)Primary outcomes included operating room, anesthesia, intensive care unit (ICU), non-ICU, and total hospital charges. Secondary outcomes included hospital length of stay, estimated blood loss (EBL), transfusion volume, and need for subsequent craniofacial surgery.ResultsAnalysis was restricted to sagittal synostosis to ensure cohort comparability. SAC patients were younger at surgery (3.7 ± 1.1 vs. 16.2 ± 19.2 months; <i>p</i> < .001) and had reduced blood donor exposure (0.86 ± 0.45 vs. 1.24 ± 0.77; <i>p</i> = .019) and shorter ICU (1.14 ± 0.36 vs. 1.44 ± 0.66 days, <i>p</i> = .029) and hospital stay (3.3 ± 0.5 vs. 5.1 ± 0.5 days; <i>p</i> < .001) compared with OCVR. Total EBL was similar between groups (18.8 ± 4.0 vs. 19.1 ± 2.7 mL/kg; <i>p</i> = .92), although blood loss at spring removal was minimal. ICU charges were lower for SAC ($3846 ± 1695 vs. $4830 ± 2428; <i>p</i> = .045), while operating-room, anesthesia, and total hospital charges were comparable (<i>p</i> > .05). Subsequent craniofacial surgery was less frequent following SAC (6.3% vs. 35.6%; <i>p</i> = .003), with all SAC reoperations representing planned staged procedures.ConclusionsIn this institutional series of sagittal synostosis repairs, SAC was associated with lower ICU charges, fewer unique blood donor exposures, and fewer subsequent craniofacial procedures compared with OCVR. Although cumulative EBL and operative duration were similar, SAC redistributed blood loss across two shorter operations separated by several months, with minimal blood loss at removal and shorter hospitalization. These findings support SAC as a safe and efficient approach for appropriately selected infants with sagittal synostosis.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3328-3333"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943339","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":"Audiological Characterization in Children With Isolated Robin Sequence During the First Year of Life: A Retrospective Study.","authors":"Bárbara Cristiane Sordi Silva, Giovana Rinalde Brandão, Adriana Guerta de Souza, Kátia de Freitas Alvarenga","doi":"10.1177/10556656251405746","DOIUrl":"10.1177/10556656251405746","url":null,"abstract":"<p><p>ObjectiveTo characterize the audiological and sociodemographic profiles of children diagnosed with isolated Robin sequence (RS) and cleft palate (CP) during the first year of life. In addition, this study aimed to propose an audiological assessment protocol for early identification of hearing loss (HL) in this population.DesignRetrospective longitudinal study analyzing secondary data from medical records.SettingSpecial Care Unit at the Hospital for Rehabilitation of Craniofacial Anomalies.PatientsFifty-eight children aged 0 to 12 months diagnosed with isolated RS and CP.InterventionsNo interventions were performed.Main Outcome MeasuresAudiological assessments revealed a high prevalence of bilateral conductive HL ranging from mild to moderate severity.ResultsMost participants resided in São Paulo state and belonged to lower-upper socioeconomic backgrounds. The most frequent risk factor for early childhood HL was neonatal intensive care for more than 5 days. No statistically significant association was found between HL risk indicators and the presence of conductive HL.ConclusionsConductive HL was identified in 39.64% of children with isolated RS and CP, with a higher prevalence observed in females. The sample demonstrated no cases of permanent and disabling HL. We recommend implementing a standardized audiological assessment protocol for infants with isolated RS and CP during the first year of life, including tympanometry and air-conduction click-evoked auditory brainstem response (ABR), with bone conduction ABR and otoscopic examination performed when clinically indicated.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3271-3279"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828933","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":"Advancing Prediction of Secondary Speech Surgery After Palatoplasty.","authors":"Jiayi Chen","doi":"10.1177/10556656251410297","DOIUrl":"10.1177/10556656251410297","url":null,"abstract":"","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3489"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858477","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 Orbitomalar Region Projection İn Patients With Operated Cleft Lip and Palate Part 2: Effect of Maxillary Position.","authors":"Gülce Tosun, Alihan Özdemir, Ayşe Gülşen, Mert Doruk, Serhat Şibar, Neslihan Üçüncü","doi":"10.1177/10556656261418522","DOIUrl":"10.1177/10556656261418522","url":null,"abstract":"<p><p>ObjectiveTo evaluate the impact of maxillary position on orbitomalar and suborbital projection by comparing patients with and without cleft with normal and retrusive maxilla, and to determine whether projection loss is primarily related to cleft pathology or maxillary retrusion.DesignRetrospective comparative cephalometric study.SettingSingle tertiary orthodontic center; records from 2010 to 2015.PatientsA total of 142 patients (74 with cleft, 68 without cleft) aged 7 to 13 years, meeting defined inclusion criteria. Patients were divided into 4 groups according to cleft status and maxillary AP position determined by SNA: retrusive maxilla with cleft (RCMx, <i>n</i> = 44), normal maxilla with cleft (NCMx, <i>n</i> = 30), retrusive maxilla without cleft (RMx, <i>n</i> = 28), and normal maxilla without cleft (NMx, <i>n</i> = 40).InterventionsNo intervention was performed.Main Outcome MeasuresLinear orbitomalar projection measurements (LOr-VP, IOr-VP, AOr-VP, SbOr1-VP, SbOr2-VP) and maxillary position parameters (SNA, ANS-VP, A-VP). Group comparisons and correlation analyses were performed using non-parametric statistics.ResultsSignificant intergroup differences were observed for all orbitomalar and suborbital projection measurements (<i>P</i> < .05). Patients with retrusive maxilla, regardless of cleft status, demonstrated lower orbital and suborbital projection values compared with those with normal maxillary position. Suborbital parameters showed the largest variation between groups. Moderate-to-strong positive correlations were found between maxillary anterior development (SNA, ANS-VP, A-VP) and orbitomalar projection.ConclusionMaxillary retrusion, rather than cleft status, appears to be a key determinant of reduced orbitomalar projection and midfacial convexity. In patients with retrusive maxilla, correction of midfacial deficiency may require consideration of infraorbital and zygomatic support in addition to maxillary advancement.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":"63 10","pages":"3423-3432"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889095","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":"Tissue Adhesive Versus Sutures for Skin Closure in Primary Cleft Lip Repair: A Systematic Review and Meta-Analysis.","authors":"Anuj Jain, Ankita Chandak, Abhilasha Yadav","doi":"10.1177/10556656251409871","DOIUrl":"10.1177/10556656251409871","url":null,"abstract":"<p><p><i>Objective</i>To evaluate the effectiveness of cyanoacrylate tissue adhesives versus conventional sutures for skin closure in primary cleft lip repair, focusing on esthetic, clinical, and patient-centered outcomes.<i>Design</i>Systematic review and meta-analysis of randomized controlled trials and comparative observational studies.<i>Setting</i>Multicenter data synthesis including studies from the United States, the United Kingdom, India, Nigeria, and the Netherlands.<i>Patients, Participants</i>A total of 442 patients undergoing primary cleft lip repair, with 402 contributing extractable outcome data.<i>Interventions</i>Epidermal closure using tissue adhesives (octyl-2-cyanoacrylate, iso-amyl cyanoacrylate, or octyl-2-cyanoacrylate with polyester mesh tape) compared with fine nonabsorbable sutures (nylon, Prolene, or Monocryl).<i>Main Outcome Measure(s)</i>Esthetic scar quality, wound complications, parental satisfaction, operative time, and scar-related secondary parameters (eg, white roll alignment, hypertrophic scarring).<i>Results</i>Eight studies met inclusion criteria, of which 2 were randomized controlled trials. Meta-analysis showed no significant difference in esthetic outcomes between adhesives and sutures (SMD -0.05, 95 % confidence interval [95% CI] [-0.28 to 0.18]; I² = 12%). Complication rates were comparable (RR 0.93, 95% CI [0.41-2.11]). Operative time was consistently shorter with adhesives, reducing closure by 5 to 7 min per case. Parental satisfaction was uniformly higher in adhesive groups. Evidence certainty was graded moderate for esthetic outcomes and wound complications, and low for operative time and satisfaction.<i>Conclusions</i>Tissue adhesives provide equivalent esthetic and complication outcomes to sutures in cleft lip repair, with added advantages of faster closure and improved parental satisfaction. Incorporating adhesives into cleft protocols may enhance efficiency and patient-centered care, though further high-quality trials with long-term follow-up are warranted.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3308-3317"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020394","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":"Predictive Capabilities of the Asher-McDade Esthetic Index for Nasolabial Revision Surgery: A Pilot Study.","authors":"Fonthip Tatiyanupanwong, Supatchai Boonpratham, Natchalee Srimaneekarn, Chaiyapol Chaweewannakorn, Yodhathai Satravaha, Supakit Peanchitlertkajorn","doi":"10.1177/10556656251415230","DOIUrl":"10.1177/10556656251415230","url":null,"abstract":"<p><p>ObjectiveThis pilot study explored the predictive capabilities of individual components and composite scores of the Asher-McDade Esthetic Index (AMEI) for determining the need for nasolabial revision surgery in patients with repaired complete unilateral cleft lip and palate (UCLP). Receiver operating characteristic (ROC) analysis and Youden's index were employed to assess predictive power and identify optimal thresholds, respectively.DesignSingle-center retrospective cross-sectional pilot studySettingCleft and craniofacial centerParticipantsThirty-two pre-adolescent patients with complete UCLP who underwent primary repair.InterventionsStandardized frontal and lateral facial photographs were rated by three calibrated plastic surgeons using the AMEI. Components assessed included nasal form, nasal symmetry, vermilion border, and nasolabial profile. A separate panel of three plastic surgeons determined the need for nose and/or lip surgical revision by majority vote, based on the same photographs. ROC analysis evaluated the predictive ability of individual AMEI components and composite scores, with cutoffs identified via Youden's Index.Main Outcome MeasuresThe predictive ability of AMEI for determining the need for nasolabial revision, using ROC analysis and Youden's Index.ResultsNasal symmetry demonstrated the highest predictive accuracy for nose revision, and vermilion border was the strongest predictor for lip revision. Although composite scores showed promising predictive potential, they did not surpass the predictive power of the strongest individual AMEI components.ConclusionThis pilot study provides preliminary evidence that the AMEI can serve as a useful objective tool to predict the need for revision surgery in patients with repaired UCLP.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3390-3397"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120824","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":"Corrigendum to \"Geometric Morphometric Study of ear Shape in Four Chinese Ethnic Minority Populations\".","authors":"","doi":"10.1177/10556656251410670","DOIUrl":"10.1177/10556656251410670","url":null,"abstract":"","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3550"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811906","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":"Examining Sociodemographic Disparities in Diagnostic Delays and Surgical Management of Non-Syndromic Craniosynostosis: A 10-Year Review.","authors":"Melanie Bakovic, Sofia A Finestone, Liara S Ortiz-Ocasio, Jennifer Goldman, Athena Zhang, Kennedy H Sun, Brandon Boyarsky, Esperanza Mantilla-Rivas, Veronica S Zhang, Patrick F O'Brien, Saige A Teti, Robert F Keating, Albert K Oh, Gary F Rogers","doi":"10.1177/10556656251411364","DOIUrl":"10.1177/10556656251411364","url":null,"abstract":"<p><p>ObjectiveTo investigate the impact of sociodemographic factors on the surgical management and outcomes of patients with non-syndromic craniosynostosis, with a focus on delays in diagnosis and intervention.DesignRetrospective cohort study.SettingTertiary pediatric hospital.PatientsThree hundred seventy-three non-syndromic patients who underwent primary craniosynostosis surgery between 2013 and 2023.Main Outcome MeasuresPrimary outcomes included age at first specialty appointment, age at diagnosis, age at surgery, and type of surgery (CVR, open cranial vault remodeling; or ES + HT, endoscopic suturectomy + helmet therapy). Secondary outcomes included postoperative complications, need for additional craniofacial procedures, and length of hospital stay.ResultsPatients undergoing CVR were older at the time of specialty appointments (median 6.6 vs. 1.9 months, P < 0.001), diagnosis (median 8.1 vs. 2.1 months, P < 0.001), and surgery (median 11.3 vs. 2.9 months, P < 0.001) compared to those undergoing ES + HT. When controlling procedure type and sociodemographic variables, private insurance was a predictor of earlier diagnosis (β=-3.06, 95% CI [-5.97, -0.16], P = 0.039) and earlier surgical intervention (β=-3.55, 95% CI [-6.67, -0.42], P = 0.026). Independent predictors of longer hospital stay included Hispanic ethnicity (β=0.45, 95% CI [0.03, 0.87], P = 0.035) and higher national Area Deprivation Index (ADI) score (β=0.014, 95% CI [0.008, 0.021], P < 0.001). After multivariable adjustment, complication rates and the need for additional craniofacial procedures did not differ significantly between ES + HT and CVR.ConclusionPatients with public insurance were more likely to experience a delay in diagnosis and, consequently, underwent a more invasive CVR procedure than privately insured patients. Hispanic ethnicity and higher ADI were associated with longer hospitalizations.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3318-3327"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946507","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":"Anterior Maxillary Distraction as an Interim Procedure for Management of Cleft Maxillary Hypoplasia.","authors":"Maria Kuriakose, Shibani A Nerurkar, Arjun Krishnadas, Arya V M, Vinanthi Vinay, Pramod Subash","doi":"10.1177/10556656251385657","DOIUrl":"10.1177/10556656251385657","url":null,"abstract":"<p><p>IntroductionManagement of cleft maxillary hypoplasia (CMH) is complex and influenced by multiple factors. While orthognathic surgery (OGS) remains a standard corrective approach, large maxillary advancement often result in compromised stability. Alternative methods, such as anterior maxillary distraction (AMD) and Le Fort 1 distraction, offer gradual advancement but may not address CMH in all dimensions. This study assesses the efficacy of staging CMH treatment using both AMD and OGS.DesignRetrospective Observational Study.PatientsUnilateral cleft lip and palate patients with at least 1 year of follow-up post-CMH correction were included.InterventionPatients were grouped by maxillary arch perimeter (MAP) and intervention: Group A (<80 mm, AMD + OGS), Group B (>90 mm, OGS only), and Group C (<80 mm, OGS only). Maxillary arch perimeter changes, OGS movement, relapse, and postoperative orthodontic treatment duration were evaluated.ResultsFifteen patients (5 per group) were included. Group A showed increased MAP by 7.84 mm post-AMD, accommodating palatally placed teeth. Mean maxillary movement during OGS was comparable in Group A (7.4 mm) and Group B (7.5 mm) but greater in Group C (11.8 mm). Relapse was the least in Group B, followed by Group A and then C. Postoperative orthodontic duration varied: 4 to 6 months for Group A, 3 to 5 months for Group B, and 12 to 16 months for Group C.ConclusionAnterior maxillary distraction effectively addresses crowding, maintains Bolton's ratio, increases MAP, and reduces the quantum of movement during subsequent OGS. A preoperative MAP ≥ 85 mm allowed good interarch intercuspation improving stability during OGS and reduced postoperative orthodontic duration. Anterior maxillary distraction proves to be a valuable interim procedure, enhancing overall treatment outcomes in CMH correction.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3208-3213"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410658","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":"Modeling of Cleft Anomalies: Enabling Bench-to-Bedside Discovery and Innovation.","authors":"Mengying Shao, Wuliang Diao, Xuan Chen, Xianghua Wang, Xudan Liu, Ge Guo","doi":"10.1177/10556656251385292","DOIUrl":"10.1177/10556656251385292","url":null,"abstract":"<p><p>Cleft lip and palate (CLP) represent a significant global health concern, being among the most prevalent congenital anomalies affecting neonates. This condition arises from the failure of fusion in embryonic development, leading to aesthetic, functional, and psychological challenges for affected individuals. By systematically reviewing existing literature, this work seeks to evaluate the strengths and weaknesses of different animal models, including mice, rats, rabbits, dogs, goats, and primates, each offering unique insights into the etiology, pathogenesis, and potential therapeutic approaches for CLP. Furthermore, the study sheds light on innovative technologies such as three-dimensional printing and genetic editing, which hold promise for enhancing our understanding and treatment of this condition. Ultimately, the objective is to provide a comprehensive overview that not only clarifies the current state of animal modeling in CLP research but also sets the stage for future investigations. The study aims to delve into the most recent advancements in CLP research, particularly focusing on the effectiveness of various animal models utilized in this field.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3490-3498"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402614","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}