Cleft Palate-Craniofacial Journal最新文献

{"title":"Grisel's Syndrome a Rare Complication of Pharyngoplasty: A Case Report and Literature Review.","authors":"Sadhishaan Sreedharan, Rodrigo Teixeira, Matthew Fell","doi":"10.1177/10556656251360593","DOIUrl":"https://doi.org/10.1177/10556656251360593","url":null,"abstract":"<p><p>Grisel's syndrome is a rare, nontraumatic atlantoaxial subluxation typically following upper airway infections or otolaryngologic procedures. We present a case of bilateral, sequential Grisel's syndrome following pharyngoplasty for velopharyngeal insufficiency in a 6-year-old female born with a cleft palate. The patient reported neck pain and torticollis starting on day 2 postoperatively. The atlantoaxial subluxations were successfully managed with halter traction and cervical immobilization. A literature review identified 8 prior cases of Grisel's syndrome post pharyngoplasty, emphasizing the need for early recognition to allow conservative treatment. This case report highlights a rare but serious complication of pharyngoplasty and the need to further investigate a patient who presents with postoperative torticollis.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251360593"},"PeriodicalIF":1.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676293","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":"Enhanced Recovery After Cleft Palate Surgery: Protocol Development and Implementation in Outreach Settings.","authors":"Roland K Assaf, Robert Younan, Mario Haddad, Wassim Najjar, Antonio Melhem, Elsa Chahine, Dana Andari, Rami S Kantar, Raj Vyas, Usama S Hamdan","doi":"10.1177/10556656251357374","DOIUrl":"https://doi.org/10.1177/10556656251357374","url":null,"abstract":"<p><p>ObjectiveTo describe and demonstrate the effectiveness and reproducibility of a modified enhanced recovery after surgery (ERAS) protocol for patients with cleft palate (CP).DesignProspective cohort study.SettingOutreach Medical Programs, resource-limited settings.PatientsPediatric patients with CP who underwent CP repair<i>.</i>InterventionsModified ERAS protocol.Main Outcome Measure(s)Complication rate, post-operative pain management, time to discharge<i>.</i>Results52 CP repairs done during three outreach medical programs were included in the study. 22 (42.3%) procedures were performed in GYE SEP 2022, 6 (11.5%) procedures in SAL JAN 2023, and 24 (46.2%) in GYE MAR 2023. The mean age was 4.9 years across all programs. 22 (42.4%) patients were between 1 and 3 years of age, 26 (50%) were between 3 and 12 years of age, and 4 (7.6%) were older than 12 years of age. Patients were equally distributed among gender with 26 (50%) being males and 26 (50%) females. A total complication rate of 5.8% was reported. 51 patients were discharged on post-op day one and only one patient was kept for an additional day for monitoring. Four patients required Fentanyl in PACU for post-operative pain, ketamine was used in 1 patient, 7 patients received Dexmedetomidine (Precedex), and ketorolac was used in 16 patientsConclusionsA modified ERAS protocol for CP surgery has been developed and implemented for outreach settings. This approach showed decreased post-operative complications, decreased length of hospital stay, and decreased opioid use while maintaining adequate pain control, establishing early enteral feeding and thus enhancing patient recovery.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251357374"},"PeriodicalIF":1.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650986","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":"Assessing Medical Student Attentional Bias in Unicoronal Craniosynostosis: An Eye-Tracking Study.","authors":"Ernest Chan, Paul Hong, Michael Bezuhly","doi":"10.1177/10556656251360841","DOIUrl":"https://doi.org/10.1177/10556656251360841","url":null,"abstract":"<p><p>ObjectiveUsing a well-established measure of attention, we aimed to objectively identify medical students' gaze patterns when assessing children with/without unicoronal craniosynostosis (UCS) and identify potential diagnostic and educational gaps in their assessment.DesignMedical student participants viewed a series of images of children with/without UCS. Eye movements were recorded using a table-mounted eye-tracking device. Dwell times for 8 interest areas (forehead, brow, eyes, nose, lower face, mouth, left ear, right ear) were compared.ParticipantsThirty medical students (21 males, 9 females, mean age = 29.9 years old) were recruited from the local medical school.Main Outcome MeasureThe main outcome measure was the cumulative dwell times (milliseconds) participants spent within the 8 facial regions (forehead, brow, eyes, nose, lower face, mouth, left ear, right ear).ResultsParticipants spent significantly more time on the brow region (P < 0.001) and less on the nose region (P < 0.05) when viewing UCS images. Furthermore, there were significantly longer dwell times to the side of the forehead contralateral to the fused suture in UCS images (P < 0.05). In control images, participants focused more on the right side of the mouth (P < 0.05). No other significant differences in dwell times were observed.ConclusionThis study demonstrates that medical students exhibit attentional biases when viewing children with UCS and focus on only some of the asymmetries seen in UCS. These findings highlight potential educational gaps emphasizing the need for targeted training in craniofacial assessment.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251360841"},"PeriodicalIF":1.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660878","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":"Bone Anchored Hearing Aid With Headband Over Cranial Orthosis: A Pilot Study.","authors":"Ana E Meza-Rochin, Gwendolyn E Daly, Miracle Uzoekwe, Lyndsay Duffus, Kristin Knight, Heather Durham, Catherine Henning, Lisa Crupi, Lori K Howell, Erik M Wolfswinkel","doi":"10.1177/10556656251351397","DOIUrl":"https://doi.org/10.1177/10556656251351397","url":null,"abstract":"<p><p>BackgroundCranial orthosis is a widely accepted treatment approach for moderate to severe deformational plagiocephaly. Custom-fit helmets molded tightly to the head are worn for 23 hours a day for several months2. This poses a challenge for children with concurrent conductive hearing loss who benefit from hearing devices, specifically bone anchored hearing aids (baha), that are intended to contact the skull directly1. We theorized the bone conducted signals could be transferred through the helmet to the baha device given its tight fit to the cranium.MethodsThis is a pilot study in which we present a case report of three patients in whom baha with headbands were used over their helmet therapy. Feedback management settings were adjusted to account for this. Given the age and development of the children, aided testing was performed.ResultsGood aided benefit was seen with using baha placement over the helmet. Optimal results were achieved with placement of the processor on the flat section of the helmet near the ear pinna. One patient, however, did not tolerate stimulus well and the baha was discontinued. For the other two patients, the baha over the helmet was utilized until they completed helmet therapy. Baha program settings were re-measured/adjusted when the device was used without the helmet. Parents reported positive responses when their child was wearing the baha compared to without.ConclusionPlacement of the baha with headband over a molding helmet is an important alternative method for patients with concurrent deformational plagiocephaly and conductive hearing loss. This modification allows for earlier baha implementation to facilitate auditory and language development, and minimize communication delays, while permitting optimal head reshaping without compromising speech development or head shape.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351397"},"PeriodicalIF":1.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650972","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":"Remote Online vs. Onsite Rating of GOSLON Yardstick Using Digital Models.","authors":"Supatchai Boonpratham, Ploy Busagornruangrat, Natchalee Srimaneekarn, Theerasak Nakornnoi, Chaiyapol Chaweewannakorn, Yodhathai Satravaha, Supakit Peanchitlertkajorn","doi":"10.1177/10556656251359503","DOIUrl":"https://doi.org/10.1177/10556656251359503","url":null,"abstract":"<p><p>ObjectivesTo assess the reliability of remote online GOSLON yardstick rating compared to a traditional onsite setting using a photogallery of a 3D dental model.DesignCrossover study.PatientsThe inclusion criteria are patients with a non-syndromic complete unilateral cleft lip and palate, with the models taken during mixed dentition, prior to any orthodontic treatment. 34 patients participated in this study.InterventionsA panel of 3 assessors rated a photogallery of digital models using the GOSLON yardstick in both onsite and remote online settings.Main Outcome MeasurementsThe level of agreement between the two settings, intra- and interrater reliability, was assessed using Cohen's weighted kappa statistics (κ), intraclass correlation coefficient (ICC), and Spearman correlation coefficient (ρ).ResultsThe level of agreement between remote online and onsite ratings exhibited a very good level of agreement (κ > 0.83; ICC > 0.95; ρ > 0.94). In addition, intrarater agreement for both rating methods also showed a very good level of agreement (κ > 0.81; ICC > 0.91; ρ > 0.94).ConclusionThis study demonstrated a very good level of agreement and correlation between the GOSLON scores of both viewing settings. This suggests that the difference in the setting, viewing environment, and device does not affect the GOSLON score results. Therefore, remote online rating is as reliable as onsite rating.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251359503"},"PeriodicalIF":1.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643983","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":"An Exploratory Investigation into the Influence of Nasopharyngoscopy Findings on VPI Surgery Selection.","authors":"Jessica L Chee-Williams, Jamie L Perry, Kate Bunton, Thomas J Sitzman","doi":"10.1177/10556656251359180","DOIUrl":"https://doi.org/10.1177/10556656251359180","url":null,"abstract":"<p><p>ObjectiveTo explore if observations on nasopharyngoscopy influence the surgical procedure selected for the management of velopharyngeal insufficiency (VPI).DesignCross-sectional survey.ParticipantsSeventeen surgeons with experience treating VPI.InterventionsReview of twenty-four nasopharyngoscopy videos with a combination of velopharyngeal closure patterns and gap sizes.Main Outcome MeasuresSurgical procedure was selected after watching a nasopharyngoscopy video. Chi-square tests were used to evaluate if, for each surgeon, procedure selection varied based on closure pattern and gap size combination. Variable importance scores were obtained from a random forest analysis to quantify contribution of nasopharyngoscopy observations on procedure selection.ResultsFour procedures accounted for 86% of all surgeries selected: Furlow double-opposing Z-Plasty (33%), palatal lengthening using buccal myomucosal flaps (20%), pharyngeal flap (19%), and sphincter pharyngoplasty (14%). Four surgeons (23.5%) significantly varied their surgical selection when different closure pattern and gap size combinations were shown on nasopharyngoscopy. Ten surgeons (58%) selected the same procedure in ≥ 50% of the 24 nasopharyngoscopy videos. Individual surgeon preference was the strongest predictor of surgical selection, accounting for 57.9% of surgical selection variance. Velopharyngeal gap size accounted for 36.5% of the variance in surgical selection, yet the specific surgeries selected based on gap size varied widely across surgeons. Closure pattern was a weak predictor, contributing 5.6% to surgical selection variance.ConclusionsNasopharyngoscopy findings influence VPI surgical procedure selection in a highly individualized, surgeon-specific manner. Among factors observed on nasopharyngoscopy, velopharyngeal gap size has a much larger influence on procedure selection than closure pattern.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251359180"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643980","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":"TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty.","authors":"Steffen G Osborn, Daniel C Bartelt, Liu Hong, Matthew A Howard, Mario Zanaty, Marlan R Hansen, Terry C Yin, Brian T Andrews","doi":"10.1177/10556656251357992","DOIUrl":"10.1177/10556656251357992","url":null,"abstract":"<p><p>BackgroundDecompressive craniectomy (DC) is a venerable clinical tool to manage moderate-to-severe traumatic brain injury (TBI). The utility of recently approved neuroinflammatory biomarkers glial fibrillary acidic protein (<i>GFAP</i>) and ubiquitin C-terminal hydrolase-L1 (<i>UCH-L1</i>) is unclear in DC patients as does the timing of cranioplasty to repair/restore the missing cranial bone. We hypothesize that DC diminishes acute neuroinflammatory biomarkers <i>GFAP</i> and <i>UCH-L1</i> and that early cranioplasty improves motor recovery following DC in moderate-to-severe TBI.MethodsA rodent TBI paradigm utilized a \"hit-and-run\" closed cortical impact to induce moderate-to-severe trauma. GFAP and UCH-L1 were quantified in CD1 mice (ELISA) in sham, TBI, and TBI-DC. Concurrently, Long-Evans rats received early or delayed alloplastic cranioplasty, with beam walk to assess motor proficiency. A 2-way ANOVA with Dunnett's post hoc determined group-level differences.ResultsGFAP and UCH-L1 were elevated in TBI at post-TBI day 1 (GFAP: <i>P</i> = .0233; UCH-L1: <i>P</i> = .0005) and partially elevated in TBI-DC (GFAP: <i>P</i> = .0603; UCH-L1: <i>P</i> = .0326). By day 7, biomarker levels converged (<i>P</i> > .05), indicating acute neuroinflammation resolution. Early cranioplasty maintained near-sham motor performance at day 4 (<i>P</i> = .9925). Absence of cranioplasty (TBI-DC) produced persistent deficits (day 4: <i>P</i> = .0319; day 11: <i>P</i> = .0069; day 18: <i>P</i> = .0112). Late cranioplasty yielded improvement, achieving near-sham results by day 11 or post-cranioplasty day 5 (<i>P</i> = .9166).ConclusionsIn this moderate-to-severe TBI model, DC significantly mitigates astroglial and neuronal biomarker expression. Timely cranioplasty further augments motor recovery, underscoring its relevance for optimizing neurological convalescence following decompressive surgery in acute TBI management.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251357992"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638563","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 New Susceptibility Gene of Nonsyndromic Orofacial Cleft Based on Syndromes Accompanied With Hypertelorism.","authors":"Si-Di Zhang, Yan-Song Lin, Si-Xuan Jia, Yan Chen, Bing Shi, Zhong-Lin Jia","doi":"10.1177/10556656251359501","DOIUrl":"https://doi.org/10.1177/10556656251359501","url":null,"abstract":"<p><p>ObjectivesGenetic studies of nonsyndromic orofacial clefts (NSOC) focus on identifying susceptibility genes and elucidating underlying pathogenesis. A correlation between orofacial clefts and hypertelorism has been established by previous studies, hinting at shared genetic risk factors.Materials and MethodsSyndromes characterized by hypertelorism and orofacial clefts were screened, followed by analysis and selection of their causative genes, resulting in 35 candidate genes. After genotyping quality control, 340 single nucleotide polymorphisms (SNPs) were analyzed. Allelic and genotypic associations were evaluated under the additive model with Bonferroni correction. Linkage disequilibrium and haplotype analysis were performed.ResultsSingle nucleotide polymorphisms that showed significant allelic associations with NSOC subtypes are notably within <i>TRAPPC9</i>, <i>TBX1</i>, and <i>ZIC2</i> genes. Single nucleotide polymorphisms within <i>TRAPPC9</i> were primarily associated with nonsyndromic cleft lip and palate (NSCLP), while SNPs within <i>TBX1</i> exhibited risk and protective effects across NSCLP, nonsyndromic cleft lip only (NSCLO), and nonsyndromic cleft palate only. <i>ZIC2</i> SNPs were significantly associated with NSCLP and NSCLO. Although 15 SNPs in <i>CDH1</i> showed allelic association with NSCLO and were in strong linkage disequilibrium, no statistically significant genotypic or haplotypic associations were identified.Conclusion<i>TRAPPC9</i>, <i>TBX1</i>, and <i>ZIC2</i> are identified as novel susceptibility genes for NSOC in the western Han Chinese population, with <i>TRAPPC9</i> and <i>TBX1</i> showing distinct risk and protective effects among subtypes. While further studies are required to confirm their role, these findings deepen our understanding of NSOC genetics, emphasize the importance of subtype analysis, and provide valuable directions for further mechanistic studies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251359501"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643981","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":"Long-Term Midfacial Growth and Speech Outcomes Following Modified Furlow Double-Opposing Z-Palatoplasty.","authors":"Sameer Shakir, Mychajlo S Kosyk, Michelle Scott, Hyun-Duck Nah-Cederquist, Marilyn Cohen, Jesse A Taylor, Scott P Bartlett, Oksana H Jackson, David W Low, Jordan W Swanson","doi":"10.1177/10556656251357779","DOIUrl":"https://doi.org/10.1177/10556656251357779","url":null,"abstract":"<p><p>ObjectiveModified Furlow palatoplasty shows favorable early speech results, however long-term outcomes of midfacial growth and speech have not been fully described.DesignA retrospective cohort study was performed of subjects undergoing modified Furlow palatoplasty for primary repair of Veau III and IV cleft lip/palate during a 20-year period. Dentofacial and speech results were analyzed at skeletal maturity using cephalometrics and Pittsburgh Weighted Speech Scores, respectively.ResultsSubjects (<i>n</i> = 186) presented with Veau III (62.9%) and IV (37.1%) clefts. Rates of oronasal fistula (ONF) and velopharyngeal dysfunction (VPD) indicating secondary surgery for speech following palatoplasty were 6.5% and 5.9% in the nonsyndromic cohort. Competent velopharyngeal mechanisms (Pittsburgh Weight Speech Score 0-2) in nonsyndromic subjects were noted in 88.3% postpalatoplasty; resonance deterioration was noted in 5.9% postorthodontic expansion and 14.7% postorthognathic surgery (cumulative VPD 27.8%). At skeletal maturity, 59.2% of nonsyndromic subjects (Veau III 51.4%, Veau IV 74.1%) demonstrated midface hypoplasia according to Steiner analysis and 54.0% ultimately underwent orthognathic surgery (OGS) (III 46.2%, IV 68.4%). Presence of midface hypoplasia correlated with Veau class (<i>P</i> < .003) and presurgical nasoalveolar molding (<i>P</i> < .02). Neither age at repair (<i>P</i> < .90), surgeon (<i>P</i> < 1.0), prior lip adhesion (<i>P</i> < .72), use of vomerine flaps at time of palate repair (<i>P</i> < .33), nor syndromic status (<i>P</i> < .074) correlated with midface hypoplasia. Veau IV clefts demonstrated the highest rate of midface hypoplasia (<i>P</i> < .004).ConclusionsSpeech outcomes in the long term indicate adequate velopharyngeal competency using the modified Furlow palatoplasty. OGS for midface hypoplasia was indicated in over half of patients presenting with severe Veau type cleft phenotypes.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251357779"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643982","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 Between Two Mucoperiosteal Flap Techniques in Repairing Small-to-Medium-Sized Hard Palate Postpalatoplasty Fistulas.","authors":"Yanan Li, Xing Yin, Bing Shi, Qian Zheng, Jingtao Li","doi":"10.1177/10556656251357460","DOIUrl":"https://doi.org/10.1177/10556656251357460","url":null,"abstract":"<p><p>ObjectivePostpalatoplasty fistula management is challenging with considerable recurrence rate. Currently, there is a lack of consensus on the optimal technique for fistula repair. Both single-layer and double-layer closures were practiced in our cleft center to manage hard palate fistulas. This study retrospectively compares the two techniques and screened factors correlated with prognosis.MethodsPatients with postpalatoplasty small-to-medium-sized fistulas treated surgically between April 2013 and January 2023 at a tertiary hospital-based cleft center were reviewed. Hard palate fistulas managed by either single-layer or double-layer mucoperiosteal flaps and followed for at least 6 months were enrolled. The shape, size, and symptoms of the fistulas were recorded both before the surgery and at the follow-up. Both univariate and multivariate analyses were performed to explore correlation between recurrence and factors including surgical technique, gender, age at surgery, primary lip and cleft palate type, presence of unrepaired cleft alveolus, as well as fistula size and length-width ratio.ResultsA total of 144 cases were included, with 57 receiving single-layer closure and 87 receiving double-layer closure. No significant difference in recurrence rates was observed between the techniques. Age at surgery and the length-width ratio of the fistula were identified as significant correlations with recurrence. Age above 11.5 years and length-width ratio below 1 were suggested as risk factors for fistula recurrence.ConclusionSingle-layer and double-layer mucoperiosteum repair demonstrated comparable efficiency in managing small-to-medium-sized hard palate fistula. Length-width ratio of the fistula and age at operation were significant prognostic factors for fistula recurrence.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251357460"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638562","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}