Cleft Palate-Craniofacial Journal最新文献

{"title":"Successful Premaxillary Reconstruction and Oronasal Fistula Closure in a Patient With VATER Syndrome With Bilateral Cleft and Missing Premaxilla.","authors":"Jayson Workman, Antonio Atte, Patrick Wong, Fabio Ritto","doi":"10.1177/10556656251408193","DOIUrl":"10.1177/10556656251408193","url":null,"abstract":"<p><p>VATER syndrome is a non-random association of birth defects affecting multiple organ systems, with orofacial clefts uncommonly reported. This study presents a unique case of a patient with VATER syndrome with a bilateral cleft lip and palate who underwent the rare surgical removal of the premaxilla during cleft lip repair, resulting in a large maxillary defect and oronasal fistula. This report highlights the successful use of non-vascularized bone graft in this setting, with 13-month follow-up demonstrating bone consolidation and fistula closure. The case adds to the evidence supporting non-vascularized bone graft for extensive maxillary defects, even with oronasal fistula.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3541-3549"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858748","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":"Helmet Therapy in Infants with Positional Skull Deformity: A Retrospective Study of 455 Patients from a German Tertiary Care Center.","authors":"Katja Himmelstoß, Lisa-Marie Lottner, Steffen Spoerl, Michael Maurer, Johannes K Meier, Antonios Moralis, Monika Friedrich, Christian Ott, Torsten E Reichert, Tobias Ettl, Felix Nieberle, Juergen Taxis","doi":"10.1177/10556656261419227","DOIUrl":"10.1177/10556656261419227","url":null,"abstract":"<p><p>ObjectiveThis study aimed to investigate the impact of helmet therapy on changes in cranial asymmetry of infants with positional cranial deformities and to identify clinical and morphometric factors associated with treatment outcome.DesignThis retrospective monocentric cohort study included 455 infants treated between 2011 and 2021.SettingData were collected using manual measurements in a tertiary care setting within the outpatient clinic of a maxillofacial surgery department in Germany.PatientsInfants with positional cranial deformities, including plagiocephaly, brachycephaly, and combined types, were included.InterventionAll patients were treated with a helmet orthosis, and data were analyzed to assess changes in cranial measurements and associated factors.Main Outcome MeasuresPredefined outcome thresholds based on cranial asymmetry reduction and prognostic factors.ResultsPlagiocephaly was the most common deformity in 332 infants. Increased ear shift (Exp(B) = 0.199; 95% CI: 0.087-0.451; <i>p ≤ .</i>001) and large initial diagonal difference (Exp(B) = 0.518; 95% CI: 0.334-0.802; <i>p = .</i>003) were correlated to unfavorable outcome. Delayed treatment was associated with lower reduction in diagonal difference (<i>r</i>s = -0.229<i>; p ≤ .</i>001), and recognized as a negative prognostic factor (Exp(B) = 0.993; 95% CI: 0.989-0.997; <i>p ≤ .</i>001). In contrast, a higher baseline cranial index increased the probability of success (Exp(B) = 1.057; 95% CI: 1.030-1.084; <i>p ≤ .</i>001).ConclusionEarly diagnosis and intervention are crucial for effective treatment of cranial deformities with helmet orthosis, especially in cases with ear shift or severe initial deformation.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3478-3488"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183075","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 Comparative Study of Cleft Management in Different Economic Settings: United States Versus Guatemala.","authors":"Emmanuel Tuchez, Juan Diego Rojas Camacho, Kalpnaben R Patel, Shilin Zhao, Rosangela Sanchez Puga, Ryan H Belcher, James D Phillips","doi":"10.1177/10556656261420132","DOIUrl":"10.1177/10556656261420132","url":null,"abstract":"<p><p>ObjectiveTo compare cleft lip and palate management between the USA and Guatemala, focusing on surgical timing, secondary procedures, and multidisciplinary access.DesignMulticenter, retrospective cohort study (2011-2024); nonrandomized, with anonymized clinical and surgical data.SettingVanderbilt University Medical Center (USA) and Moore Pediatric Surgery Center (Guatemala). U.S. care was continuous; care in Guatemala was provided through short-term surgical missions.Patients1693 patients aged 0-21 years with cleft lip and/or palate (790 Guatemala; 903 USA). Patients with Tessier clefts or non-Guatemalan residency (for the Guatemalan cohort) were excluded.InterventionsPrimary and secondary cleft surgeries and multidisciplinary interventions.Main Outcome MeasureAge at primary surgery, cleft type, sex, secondary procedures, palatal fistula, velopharyngeal insufficiency, dental/ear interventions, and sociodemographics (Guatemala).ResultsGuatemalan patients underwent primary cleft lip and palate repairs at significantly older ages (<i>p < </i>.001) and had higher rates of palate fistula (24% vs. 7%), fistula repair (13% vs. 7%), and lip revision (15% vs. 8%) (<i>p < </i>.001). Access to multidisciplinary care was greater in the USA (myringotomy tubes: 70% vs. 10%; dental restoration: 24% vs. 17%; <i>p < </i>.001). Among Guatemalan patients, 53% lived in rural regions and traveled a mean 3.3 h to access care.ConclusionsSignificant disparities exist in cleft lip and palate management between Guatemala and the USA, marked by delayed surgical intervention beyond the optimal developmental window. Overcoming systemic, geographic, and socioeconomic barriers through integrated, sustainable, locally supported care models is critical to enhancing outcomes in resource-limited settings.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3551-3564"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214696","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":"Factor Affecting the Receiving Repeated Ventilation Tube Insertion in Children With Cleft Palate.","authors":"Thanakit Malaikritsanachalee, Vannipa Vathanophas, Sarut Chaisrisawadisuk, Kitirat Ungkanont, Archwin Tanphaichitr, Thanakrit Wannarong","doi":"10.1177/10556656251414503","DOIUrl":"10.1177/10556656251414503","url":null,"abstract":"<p><p>ObjectiveTo identify factors associated with repeated ventilation tube insertion (VTI) in children with cleft palate (CP) who developed otitis media with effusion (OME) before 6 years of age, and to construct a practical risk prediction scoring system.DesignRetrospective cohort study.SettingTertiary care academic hospital.ParticipantsMedical records of 127 children with CP who underwent both myringotomy with VTI and palatoplasty between 2007 and 2023 were reviewed. Patients were classified into single VTI (<i>n</i> = 55) and repeated VTI (<i>n</i> = 72) groups.InterventionsAll participants received myringotomy with VTI as standard OME management. Palatoplasty techniques included intravelar veloplasty and double-opposing Z-plasty, with or without hamulus fracture.Outcome MeasuresTen potential risk factors were evaluated, including craniofacial syndromes, premyringotomy hearing level, acute otitis media history, cleft type and gap width, middle ear fluid type, tympanic membrane (TM) retraction, surgeon level, palatoplasty technique, and hamulus fracture. Logistic regression was used to develop a predictive scoring system.ResultsMultivariate analysis identified thick middle ear fluid (odds ratio (OR) 3.18, <i>P</i> = .008), TM retraction (OR 4.06, <i>P</i> = .043), and premyringotomy hearing level >40 dB (OR 3.50, <i>P</i> = .010) as independent predictors of repeat VTI. A 0 to 4 point scoring system showed acceptable discrimination (area under the curve = 0.732).ConclusionChildren with TM retraction, thick middle ear fluid, or hearing loss >40 dB are at higher risk for repeated VTI. This scoring system supports early identification, caregiver counseling, and closer follow-up to optimize middle ear outcomes.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3470-3477"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020304","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":"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":"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":"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":"","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":"","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}