Cleft Palate-Craniofacial Journal最新文献

{"title":"Does the Rigid External Distraction Device Allow for Long-Term Control of Maxillary Pitch in Cleft Maxillary Distraction?","authors":"Alexander T Mathews, Brian E Kinard","doi":"10.1177/10556656261431242","DOIUrl":"10.1177/10556656261431242","url":null,"abstract":"<p><p>ObjectiveIt has been reported that the rigid external distraction (RED) device is unable to intentionally alter the maxillary pitch following consolidation (short term). The purpose of this study is to assess the long-term ability of RED to intentionally control the maxillary pitch.DesignRetrospective cohort study.SettingInstitutional practice.PatientsA retrospective cohort of 40 patients with cleft maxillary hypoplasia meeting the inclusion criteria.Main outcome measuresCephalometric changes and alteration in palatal plane angle.MethodsCephalometric analysis was completed standardized lateral cephalograms. Predistraction and long-term follow-up variables were compared via a paired <i>t</i> test.ResultsThe mean age at surgery of 12.2 ± 3.7 years. Through distraction osteogenesis, the mean change in the angles sella-nasion-A-point angle, sella-nasion-B point angle, and A-point-nasion-B-point angle were 4.8 ± 5.9, 2.4 ± 3.5, and 2.4 ± 5.4, respectively. The mean change in the palatal plane angle was -2.1 ± 4.7. The mean change in the vertical position of the anterior nasal spine and posterior nasal spine in relation to the Frankfort horizontal were -0.7 ± 4.0 mm and 0.9 ± 4.1 mm, respectively. The mean percent of maxillary advancement relative to maxillary length was 28.0 ± 12.1%.ConclusionThis study documents the long-term findings of RED in a cleft lip and palate population. Despite the design of the RED device to allow for a clockwise rotation of the maxilla, a persistent counterclockwise rotation of the maxilla was found. This study demonstrates that RED reliably allows for long-term horizontal lengthening of the maxilla but does not predictably allow for control of the maxillary occlusal plane.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3798-3804"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464162","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 on the Success of Secondary Alveolar Bone Grafting Performed Below 12 Years and On or After 12 Years of Age for Patients With Cleft Alveolus: A Systematic Review and Meta-Analysis.","authors":"Rajeswari Siva, Balavenkata Bharathi Chaturvedula, Saikrupa Ganesan, Badri Thiruvenkatachari","doi":"10.1177/10556656261420691","DOIUrl":"10.1177/10556656261420691","url":null,"abstract":"<p><p>AimThe aim of this systematic review and meta-analysis was to compare the outcomes of secondary alveolar bone grafting (SABG) performed before and after 12 years of age in patients with nonsyndromic cleft alveolus.MethodAll relevant studies from database untill September 2024 were identified through all relevant databases. Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), prospective, and retrospective studies were included.PopulationPatients with cleft alveolus who underwent SABG using iliac crest bone graft.InterventionEarly SABG performed below 12 years.ComparisonSABG performed on or after 12 years of age.Primary outcomeBone fill assessed through radiographic imaging techniques. Secondary outcomes included skeletal relationship, canine eruption, Asher-Mcdade index, Goslon yardstick index, presence of oronasal fistula, and revision surgeries. All articles were screened for the title, abstract, and full text by 2 reviewers independently and in duplicate. Risk of bias was assessed for RCT using Cochrane's risk of bias tool and the CCT was assessed using the ROBINS-I tool.ResultsOf the 3545 records identified, 9 studies met the inclusion criteria for qualitative and quantitative synthesis. Eight of the 9 included studies were rated as having moderate to serious risk of bias, and one judged as critical risk of bias. There is very low-quality evidence in favor of secondary grafting performed below 12 years of age compared to secondary grafting performed on or after 12 years.ConclusionFuture high-quality RCTs with standardized protocols are necessary to determine the most effective timing for SABG in cleft care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3593-3607"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214674","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":"Levator Veli Palatini Reconstruction Using an Autologous Tendon Graft in Velopharyngeal Insufficiency: What I Do.","authors":"Mohammad Ali Hoghoughi, Sara Hashemi, Zahra Kalkateh","doi":"10.1177/10556656261422851","DOIUrl":"10.1177/10556656261422851","url":null,"abstract":"<p><p>BackgroundSevere velopharyngeal insufficiency following salvage surgery poses a major challenge for cleft surgeons, particularly when repeated operations have left the soft palate both shortened and densely scarred.SolutionA tendon graft technique for levator veli palatini reconstruction is described, using an autologous palmaris longus (PL) or, when absent, a flexor carpi radialis (FCR) tendon graft to re-establish the muscular function necessary for velopharyngeal closure.NoveltyUnlike approaches that only address tissue deficiency, this method restores the levator sling by connecting residual muscle stumps with autologous tendon, thereby reconstituting anatomical continuity. In the present case, PL was absent, and FCR was successfully used as the graft.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"4017-4019"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286010","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":"Simultaneous Orthognathic Surgery and Costal Bone Grafting in Hemifacial Microsomia: A Rare Case Report and Literature Review.","authors":"Chi Hyun Lee, Hyun Seung Lee, Youn-Kyung Choi, Lun-Jou Lo, So Yeon Jung, Rafael Denadai, Hyung Joon Seo","doi":"10.1177/10556656261426396","DOIUrl":"10.1177/10556656261426396","url":null,"abstract":"<p><p>Hemifacial microsomia (HFM) is a congenital craniofacial anomaly frequently associated with mandibular hypoplasia. Achieving stable correction in severe cases remains challenging due to abnormal mandibular anatomy and deficient temporomandibular joint structures. We report a rare revision case of a 20-year-old female with type IIA HFM who developed progressive postoperative resorption following two-jaw surgery, resulting in a \"floating\" ramus-condyle segment and subsequent recurrent facial asymmetry. Revision surgery consisted of unilateral sagittal split ramus osteotomy on the unaffected side, combined with long-plate fixation and costal bone grafting on the affected side. A distal portion of the harvested costal bone was trimmed and vertically split into smaller fragments and interposed as free bone grafts between the proximal and distal mandibular segments, while the main portion was applied laterally as an onlay graft. Postoperative follow-up confirmed preservation of mandibular height with an acceptable occlusion, and secondary fat grafting further refined the soft-tissue contour. This case suggests that integrating orthognathic surgery with autogenous bone grafting may provide a durable solution in complex revision scenarios. It also highlights the importance of individualized planning and combined skeletal-soft tissue approaches to achieve favorable aesthetics.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3987-3994"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345503","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 \"Neuroendocrine Axis Investigation in Patients with Arhinia, Hemiarhinia and Associated Malformations\".","authors":"","doi":"10.1177/10556656261425765","DOIUrl":"10.1177/10556656261425765","url":null,"abstract":"","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"4020"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207987","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":"Piloting Patient Reported Outcome Measures in Cleft Lip and Palate Services in Aotearoa New Zealand.","authors":"Kenny Ardouin, Nicola Stock, Tika Ormond, Phoebe Macrae","doi":"10.1177/10556656261431254","DOIUrl":"10.1177/10556656261431254","url":null,"abstract":"<p><p>ObjectiveStandardized patient-reported outcome measures (PROMs) are rarely used in cleft lip and palate (CL/P) care within New Zealand (NZ). This pilot study sought to obtain a baseline of patient-reported outcomes in NZ and evaluate clinicians' experiences of implementing PROMs into CL/P services.DesignA mixed methods cross-sectional design using CLEFT-Q scales. Data were compared to published CL/P CLEFT-Q norms using <i>t</i>-tests, and within-group differences were investigated. Qualitative interviews were analyzed using codebook thematic analysis.SettingFive CL/P teams in Aotearoa New Zealand.ParticipantsPatients aged 12+ years (<i>n</i> = 101) were recruited through the five Health NZ CL/P teams between April 2023-March 2024. Five CL/P team members responsible for recruitment participated in an interview at the conclusion of the trial.ResultsCompared with normative data, patients reported more favorable outcomes on speech distress and school function, and poorer psychological function. Speech and social function scores were aligned with CL/P norms. Patients aged 18+ reported the lowest psychological functioning and females reported the lowest social functioning. Clinicians recognized the value of PROMs, yet highlighted concerns about insufficient resourcing to administer, review, and provide follow-up.ConclusionsPsychological function is indicated as an area of concern, particularly for adults with CL/P. Routine use of PROMs would evaluate change in measures of function over time and enhance patient-centered holistic care. Greater personnel and IT resourcing would facilitate routine implementation of PROMs in CL/P teams.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3805-3816"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693035","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":"Can the Social Vulnerability Index Enhance Models Predicting Adherence to Craniofacial Speech Evaluations?","authors":"Bo Hyun Kong, Katherine Dillon, Colin M Brady, Stefanie E Hush, Alexis Tashima, Magdalena Soldanska, Joseph K Williams, Kazlin N Mason","doi":"10.1177/10556656261436717","DOIUrl":"10.1177/10556656261436717","url":null,"abstract":"<p><p>ObjectiveTo determine whether the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) influences models of adherence to speech evaluations beyond individual demographic and clinical factors.DesignRetrospective cohort analysis.SettingTertiary children's hospital in the United States.ParticipantsFive hundred thirty-five children with cleft-related diagnoses scheduled for speech evaluations.Main Outcome MeasureAdherence to initial and follow-up speech evaluations.ResultsSVI was not predictive for adherence in logistic regression models. Children with private insurance had higher odds (OR) of attending initial evaluation (OR = 2.14, <i>P</i> < .001). Those with more severe cleft phenotypes were more likely to attend both initial (ORs 4.11-4.35, <i>P</i> < .001) and follow-up visits (ORs 6.29-7.49, <i>P</i> < .001). Children with velopharyngeal dysfunction and compensatory errors were also more likely to remain engaged in care.ConclusionSVI did not improve prediction of adherence. Insurance type, cleft phenotype, and speech function are the dominant factors influencing adherence to recommended speech evaluations.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3963-3968"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610345","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":"Disparities in Cleft Care for Hispanic/Latino Patients in the United States: A Systematic Review and Meta-Analysis.","authors":"Antoinette T Nguyen, Rena A Li, Robert D Galiano, Arun K Gosain","doi":"10.1177/10556656261420517","DOIUrl":"10.1177/10556656261420517","url":null,"abstract":"<p><p>ObjectiveTo systematically evaluate disparities in access, timing, and outcomes of cleft care for Hispanic/Latino patients in the United States.DesignSystematic review and random-effects meta-analysis conducted per PRISMA guidelines (PROSPERO CRD420251053224).SettingUS-based studies using national databases, state registries, and institutional cohorts.Patients, ParticipantsHispanic/Latino children with cleft lip and/or palate compared to non-Hispanic White children.InterventionsPrimary cleft lip and palate repair and secondary cleft-related procedures, including alveolar bone grafting.Main Outcome Measure(s)Timing of surgical interventions, postoperative complications, mortality, hospital charges, secondary procedure utilization, and patient-reported outcomes.ResultsTwenty-eight studies encompassing 30,006 Hispanic/Latino patients met inclusion criteria. Eight studies addressed surgical timing: Hispanic/Latino patients had significantly delayed primary repairs (eg, adjusted hazard ratio [aHR] 0.90 for cleft lip repair; odds ratio [OR] 2.76 for delayed palate repair) and higher rates of bone grafting after age 12 (24.4% vs. 19.4%, <i>P</i> = .0049). Three studies reported mixed patterns of secondary procedure utilization, with underuse of some operations (OR 0.29 for higher surgery frequency) but overrepresentation in cleft rhinoplasty (OR 1.36). Two national datasets showed elevated cleft-related mortality (OR 1.54; HR 1.3-1.7). While postoperative complication rates were largely equivalent, Hispanic/Latino patients experienced longer hospital stays and higher charges in several analyses. Meta-analysis of 2 studies on delayed surgery yielded a pooled OR of 2.11 (95% confidence interval 0.23-19.80) with low heterogeneity but wide uncertainty.ConclusionsHispanic/Latino patients face multifaceted disparities in cleft care-particularly delayed surgery and fragmented follow up-despite comparable technical outcomes. Targeted interventions addressing structural, linguistic, and cultural barriers are needed to advance equity in cleft treatment.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3646-3661"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286005","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":"Decision-Making at the Transition Period: Widening the Lens Around Psychosocial and Cultural Factors in Cleft Orthognathic Surgery.","authors":"Holly Clegg, Kiki Mastroyannopoulou, Eliane Young","doi":"10.1177/10556656261439955","DOIUrl":"10.1177/10556656261439955","url":null,"abstract":"<p><p>ObjectiveTo explore what factors are considered by multidisciplinary team (MDT) professionals working in cleft lip and palate services when supporting young people in their decision-making for orthognathic surgery (OS) and how professionals understand and manage ethical dilemmas that arise.DesignA qualitative design was employed in which semistructured interviews were conducted remotely with NHS staff.SettingNine participants were interviewed across four NHS cleft services in the United Kingdom.ParticipantsThe sample consisted of three Speech and Language Therapists, three Orthodontists, and three Surgeons involved in decision-making for OS.ResultsReflexive Thematic Analysis revealed three key themes and seven sub-themes:\"navigating the decision-making process,\" \"Team-Centric,\" and 'Health Inequalities impacting on access to cleft services. Within these themes, professionals reflected on positions of power, the MDT environment, valued contribution of different professionals, external influences impacting on shared decision-making (SDM) and barriers to accessing care.ConclusionsThe findings highlight the complex nature of balancing patient autonomy and beneficence during the decision-making process for OS while bringing awareness to factors that may pose a barrier to decision-making such as the presence of health inequalities, power dynamics and conditions of the MDT environment. The importance of optimizing the SDM environment and creating opportunities for liaison, particularly earlier in the pathway, are discussed. It is recommended that future research explores the impact of health inequalities on access to cleft care further, recognizing those that are currently disadvantaged in their treatment journey.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3900-3910"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730602","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":"Cleft Lip and Palate is Common in PORCN-Related Focal Dermal Hypoplasia in Asians: Three New Case Reports and Literature Review.","authors":"Joshua C K Chan, Phoebe K W Wu, Wing Chung Yiu, Stephanie K L Ho, Ho-Ming Luk","doi":"10.1177/10556656261431892","DOIUrl":"10.1177/10556656261431892","url":null,"abstract":"<p><p>Focal dermal hypoplasia is an X-linked dominant genetic disorder predominantly affecting females, caused by loss-of-function variants in the <i>PORCN</i> gene, characterized by ectodermal, skeletal, craniofacial and ocular structural abnormalities. We report three cases with <i>de novo</i> novel variants, and performed a comprehensive review of the clinical features of this disorder focusing on Asian patients, and identified significant differences compared with previous literature focusing on Caucasian patients. Cleft lip and palate is a frequently reported feature in Asian patients, but not in Caucasians. This improves the understanding of this rare disease in particular ethnic-specific differences.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"4000-4007"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464167","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}