Cleft Palate-Craniofacial Journal最新文献

{"title":"When Need Exceeds Support: Lower Medicaid Reimbursement for Cleft Orthodontia in High Pediatric Enrollment States.","authors":"Ronald R McCall, Ashlie Elver, John David West, Hannah Benton, Kendall C Pitre, Ian C Hoppe, Laura S Humphries","doi":"10.1177/10556656261499060","DOIUrl":"https://doi.org/10.1177/10556656261499060","url":null,"abstract":"<p><p>ObjectiveTo analyze the association between Medicaid provider reimbursement for cleft lip and palate (CL/P) procedures and state-level economic factors.DesignCross-sectional study of publicly available 2025 state Medicaid provider reimbursement rates associated with CL/P procedures. Statistical analysis compared provider reimbursement and demographic factors.SettingNational sample of Medicaid reimbursement fee schedules.ParticipantsFifty U.S. states utilizing fee-for-service reimbursement.Main Outcome Measure(s)Reimbursement Rates for D8020 (Phase I: Limited Orthodontia, Transitional Dentition) and D8080 (Phase II: Comprehensive Orthodontia, Adolescent Dentition), CPT 42210 (Palatoplasty for Cleft Palate with Bone Graft), Pediatric Population of Medicaid and Children's Health Insurance Program.ResultsD8080 reimbursement was negatively correlated with pediatric Medicaid enrollment (<i>r = </i>-0.375, <i>p = </i>0.014). Multivariate linear regression predicted D8080 reimbursement, explaining 46.9% of variance (adjusted R² = 0.41). Higher reimbursement was associated with higher cost of living (β = 0.39, <i>p = </i>0.007), poverty (β = 0.51, <i>p < </i>0.001), and Medicaid expansion (β = 0.27, <i>p = </i>0.041), but lower in states with greater pediatric enrollment (β = -0.53, <i>p < </i>0.001).ConclusionsMedicaid provider reimbursement for comprehensive orthodontic treatment is independently associated with state socioeconomic characteristics. Reimbursement decreased with higher enrollment. This trend may further limit provider availability for low-income families with existing barriers in access to care. These findings suggest that Medicaid reimbursement may not adequately scale with pediatric beneficiary demand, potentially limiting access to multidisciplinary treatment.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261499060"},"PeriodicalIF":1.3,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240259","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":"Fractal Analysis of Mandibular Condylar Trabecular Bone Structure in Cone-Beam Computed Tomography Images of Individuals with Cleft Lip and Palate.","authors":"Mevlude Yuce Polat, Şeyda Alkan, Nurbanu Şahin, Mehmet Veysel Kotanli, Mehmet Emin Doğan, Sedef Kotanli","doi":"10.1177/10556656261496627","DOIUrl":"https://doi.org/10.1177/10556656261496627","url":null,"abstract":"<p><p>ObjectiveTo evaluate mandibular condylar trabecular bone structure in individuals with cleft lip and palate (CLP) using cone-beam computed tomography (CBCT)-based fractal analysis.DesignRetrospective imaging study.SettingDepartmental dentomaxillofacial radiology archive.Patients, ParticipantsCBCT images of 33 individuals with CLP (11 right-sided unilateral, 16 left-sided unilateral, and 6 bilateral clefts) and 38 individuals without CLP with a comparable age distribution were analyzed.InterventionsNot applicable.Main Outcome Measure(s)Fractal dimension (FD) values of the right and left mandibular condyles measured on standardized coronal, sagittal, and axial CBCT sections. Intra- and interobserver agreement were assessed with intraclass correlation coefficients.ResultsIntra- and interobserver agreement was excellent (ICC > 0.90). FD values tended to be lower in individuals with CLP than in individuals without CLP. After Benjamini-Hochberg false discovery rate correction for multiple comparisons, only the between-group difference in the left sagittal plane remained statistically significant (FDR-adjusted <i>p = .</i>018). No significant group-by-side interaction was observed in the coronal, sagittal, or axial planes (all FDR-adjusted <i>p > .</i>05). In individuals with unilateral CLP, no significant ipsilateral-contralateral differences in condylar FD were observed.ConclusionsIndividuals with CLP tended to show lower mandibular condylar FD values than individuals without CLP; however, the between-group difference did not differ significantly between the right and left sides. These findings suggest that CLP may be associated with radiographically detectable differences in condylar trabecular bone complexity. Larger longitudinal studies are needed to clarify the clinical and functional relevance of these findings.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496627"},"PeriodicalIF":1.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197434","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":"Cleft Lip Repair Associated <i>Serratia marcescens</i> Infection: A Rare Case Report and Literature Review.","authors":"Amina Al-Yaqoobi, Ruqaya Al-Abri, Fatma Al Habsi, Sheikhan Al Hashmi","doi":"10.1177/10556656261496974","DOIUrl":"https://doi.org/10.1177/10556656261496974","url":null,"abstract":"<p><p>Cleft lip deformity is the most common birth defect, characterized by failure of the union of the medial nasal process and maxillary prominence. A variable range of cleft lips could be unilateral or bilateral, complete or incomplete, cleft lip with or without cleft palate. Diagnosis of a cleft lip is typically made through clinical examinations. Surgical repair is the ultimate management of cleft lips, which restores their normal appearance. Repairing a cleft lip could be associated with certain complications, including infection, dehiscence, notching, and post-op hypertrophic scarring. Nevertheless, infection can occur after cleft lip repair surgery, but infection with <i>Serratia marcescens</i> is typically uncommon.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496974"},"PeriodicalIF":1.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197411","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":"Genetic Heterogeneity in Cleft Lip and/or Palate With Alveolar Cleft: A Targeted Analysis of NHEK-Active Enhancer Variants.","authors":"Yan Chen, Lingfeng Luo, Wenguang Tang, Lixian Chen, Yang Li, Chenghao Li, Bing Shi, Zhonglin Jia","doi":"10.1177/10556656261495252","DOIUrl":"https://doi.org/10.1177/10556656261495252","url":null,"abstract":"<p><p>ObjectiveTo identify susceptibility loci for nonsyndromic cleft lip and/or palate with cleft alveolus involvement and to elucidate subtype-specific regulatory mechanisms in a Chinese population.DesignSubtype-stratified case-control targeted association analysis.SettingTertiary medical center for orofacial cleft treatment in western China.Patients, ParticipantsA total of 3009 unrelated Chinese individuals from two previously generated Genome-wide association study datasets, comprising 445 cases with cleft lip extending through the alveolus without palatal involvement (CLCA), 309 cases with cleft lip and palate extending through the alveolus (CLPCA), and 754 combined CL/P with cleft alveolus (CL/PCA) cases, along with unaffected controls.InterventionsNot applicable.Main Outcome Measure(s)Single nucleotide polymorphisms associations with CLCA, CLPCA, and combined CL/PCA phenotypes at Bonferroni-corrected significance (P < 3.65 × 10^-6), with functional annotation integrating ENCODE chromatin states, Hi-C interactions, and GTEx eQTL data.ResultsThree SNPs (rs10863790, rs2064163, rs4880224) reached study-wide significance in the combined CL/PCA and CLCA subgroups but not in CLPCA. rs10863790 showed the highest population attributable risk in CLCA (29.63%). All three variants overlap NHEK-active enhancers and regulate craniofacial development genes (<i>IRF6, UTP25, TRAF3IP3, BNIP3, JAKMIP3, PPP2R2D</i>) through chromatin looping, pluripotency factor binding, and FOX family transcription factor recruitment.ConclusionsThese findings reveal pronounced genetic heterogeneity between CLCA and CLPCA subtypes, underscoring the necessity of subtype-stratified approaches for precision medicine in orofacial cleft management.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261495252"},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185446","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":"Stomatognathic Functional Adaptation in Patients With Unilateral Cleft Lip and Palate: A T-Scan, Surface Electromyography and Joint Vibration Analysis Study.","authors":"Minakshi Tibrewal, Puneet Batra, Aditya Talwar, Ashish Kumar Singh","doi":"10.1177/10556656261496415","DOIUrl":"https://doi.org/10.1177/10556656261496415","url":null,"abstract":"<p><p>ObjectiveTo compare the temporomandibular joint (TMJ) health, occlusal load distribution, masticatory efficiency and masticatory muscle function in patients with unilateral cleft lip and palate (UCLP) against age- and gender-matched noncleft controls, using a multimodal assessment approach.DesignA cross-sectional comparative study.SettingsAll measurements were performed by 2 calibrated examiners.PatientsIn total, 19 UCLP patients (Group 1) and 19 noncleft controls (Group 2).Main Outcome MeasureOcclusal load distribution was evaluated using computerised occlusal analysis (T-Scan). Surface electromyography (sEMG) of the anterior temporalis and masseter muscles was recorded at rest, during chewing and at maximum voluntary clenching (MVC). Masticatory efficiency was assessed using colorimetric analysis, and TMJ function was evaluated using joint vibration analysis (JVA).ResultsOcclusal timing parameters were comparable between groups. During maximum bite force (MBF), Group 1 demonstrated significantly lower MBF on the cleft side (38.64 ± 7.00%) than Group 2 (51.48 ± 4.63%). At MVC, normalised sEMG activity was significantly higher bilaterally in Group 1 compared with controls for both muscles. Masticatory efficiency was significantly reduced in Group 1 (optical density 0.42 ± 0.15 vs 0.76 ± 0.15). JVA showed significantly elevated noncleft-side total integral in Group 1 versus Group 2, and integral <300 Hz on the noncleft side, while the significantly elevated integral >300 Hz on the noncleft side also persisted.ConclusionUCLP patients exhibit significant occlusal force asymmetry, reduced masticatory efficiency and a task-dependent pattern of masticatory muscle recruitment. TMJ vibrational alterations were predominantly of low frequency, suggestive of structurally forced load redistribution and neuromuscular compensation.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496415"},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185419","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":"Validation of a Low-Cost Surgical Simulation Model for Cleft Lip Repair Training: A Multicentre Trainer-Trainee Workshop Study.","authors":"Madhubari Vathulya, Smruti Srinivasan, Hemanth Kumar K, Deviprasad Mohapatra, Konstanze Scheller, Peter Kessler","doi":"10.1177/10556656261495084","DOIUrl":"https://doi.org/10.1177/10556656261495084","url":null,"abstract":"<p><p>ObjectiveTo evaluate the face, content and construct validity of a low-cost unilateral cleft lip trainer through a multicentre trainee-trainer workshop.DesignProspective multicentre validation study.SettingThree accredited plastic surgery training centres.Patients/ParticipantsSixty-two plastic surgery residents participated in standardised simulation workshops.InterventionsParticipants underwent lectures, video demonstrations and supervised practice of unilateral cleft lip repair using the low-cost simulator. Pre- and post-workshop questionnaires assessed self-reported knowledge and procedural understanding. Participants rated the model for face and content validity using a 5-point Likert scale. Faculty assessed simulator-based performance using a 10-point checklist.Main Outcome Measure(s)Face validity, content validity, construct validity, pre- and post-workshop knowledge scores, repair time, suture-line integrity and lip-height symmetry.ResultsKnowledge scores increased from 55% to 87%, with significant improvement in chronological recall of repair steps (P < .001). Face validity exceeded 90% across anatomical and procedural domains, with teaching usefulness rated highest (98%). Content validity was strongly supported, with 99% of participants recommending curriculum integration. Construct validity demonstrated significant discrimination between first-, second- and third-year residents, with mean performance scores of 7.1, 8.4 and 9.6, respectively (P < .001). Repair times decreased with increasing training level, while senior trainees achieved superior repair quality.ConclusionsThe low-cost unilateral cleft lip trainer demonstrated favourable face, content and construct validity within a structured workshop setting. Its affordability and reproducibility support its use as an adjunct for procedural rehearsal and assessment in plastic surgery training.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261495084"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168451","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 of Human Costal-Derived Chondrocyte Donor Sites and Microtia-Derived Chondrocytes for Auricular Tissue Engineering.","authors":"Ashton Rosenbloom, Thomas Gasbeck, Lana Mamoun, Arya Sherafat, Nikhil Prabhakar, Michelle Toledano, Mary Ziegler, Alan Widgerow, Miles J Pfaff","doi":"10.1177/10556656261496626","DOIUrl":"https://doi.org/10.1177/10556656261496626","url":null,"abstract":"<p><p>ObjectiveTo compare microtia-derived chondrocytes (MCs) with costal cartilage-derived chondrocytes (CCs) and determine whether costal cartilage harvest location influences chondrocyte proliferative and chondrogenic potential for auricular cartilage tissue engineering.DesignExperimental laboratory study using native tissue analysis and in vitro cell culture.SettingSingle-center laboratory study.PatientsNative auricular and costal cartilage samples were collected from four paired pediatric patients undergoing autologous microtia reconstruction.Interventions: MCs and costal chondrocytes isolated from proximal/osteochondral (PCs), distal/sternal (DCs), and medial costal (CCs) regions, were expanded in normal cell culture and 3D pellet culture.Main Outcome MeasuresType II collagen, glycosaminoglycans, total collagen, proteoglycans, and Ki67 were evaluated via immunohistochemistry (IHC). Cell proliferation was measured using cell counting kit-8 (CCK8), and gene expression of chondrogenic, osteogenic, and proliferative markers was analyzed in monolayer and 3D pellet cultures.ResultsNative microtia and costal cartilage demonstrated similar type II collagen and proteoglycan content across regions. Native microtia tissue showed greater Ki67 staining than medial and proximal costal cartilage (p < 0.05 and p < 0.01, respectively), whereas glycosaminoglycan staining was greater in costal cartilage (p < 0.05). In normal cell culture, all cell types demonstrated similar proliferative activity. In 3D pellet culture, PCs had higher Ki67 staining than DCs and MCs (p < 0.01). In CC pellet cultures, Ki67 and COL2A1 expression was increased.ConclusionCostal CCs demonstrated distinct chondrogenic characteristics based on harvest site. These findings support a more targeted utilization of costal CCs for auricular cartilage tissue engineering.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496626"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172016","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":"Disability Identity and Critical Consciousness Among People with Facial Differences.","authors":"Marisa A Krauter, Kathleen R Bogart","doi":"10.1177/10556656261494335","DOIUrl":"https://doi.org/10.1177/10556656261494335","url":null,"abstract":"<p><p>People with facial differences (FD) experience unique manifestations of stigma, possibly contributing to the high variability in whether they identify as disabled. Three levels of identity specificity can describe how much people with FDs identify with: having a diagnosis, having an FD identity, and having a disability. Critical consciousness, which refers to awareness of and action against injustice, may help mitigate stigma and impact identity.ObjectiveThis study examined associations between demographics, identities, critical consciousness, and life satisfaction.Participants & DesignAdults with FDs were recruited through social media and FD organizations to complete a cross-sectional online questionnaire.Main Outcome & MeasuresThree open-ended questions, Disability Personal Identity Scale, Critical Consciousness Scale, and Satisfaction with Life Scale were completed. Qualitative content analysis described how they learned about the term FD and thoughts about identifying with having a disability. Multiple regressions described relationships between each identity and critical consciousness as well as identities with life satisfaction.ResultsParticipants (N = 60) were mostly white (81%) women (80%) with a college education (88%). All participants self-categorized as having an FD and 59% self-categorized as disabled. Themes of disability identification depended on: health and medical treatment, comparisons to \"normal\" life, impacts on social/public interactions, and the less frequent societal attitudes. Identifying with their diagnosis and higher education were associated with higher critical consciousness. Study variables were not associated with life satisfaction.ConclusionsGreater awareness of identities and utilizing the term 'FD' in healthcare settings may help to connect more people to FD community.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261494335"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168429","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":"Patterns of Orofacial Cleft Phenotypes and Their Associated Sequelae: A 3-Year Retrospective Study at a Tertiary Referral Hospital in West Africa.","authors":"Edmond Kubi Appiah, Joseph Nimako-Boateng","doi":"10.1177/10556656261496582","DOIUrl":"https://doi.org/10.1177/10556656261496582","url":null,"abstract":"<p><p>ObjectiveTo determine the demographic distribution, anatomical patterns and associated complications of orofacial clefts (OFCs) at a major tertiary referral centre in Ghana.DesignA retrospective cross-sectional review of patient records.SettingThe Cleft Centre of the Oral and Maxillofacial Surgery Department, a tertiary Institution in West Africa.Patients/participantsRecords of all patients managed for OFCs between January 2017 and December 2019. After exclusions for incomplete data, 189 patients were included.InterventionsNot applicable (observational study).Main outcome measure(s)Primary outcomes were frequencies and percentages of cleft types (cleft lip with or without cleft alveolus [CL ± A], cleft lip and palate [CLP], cleft palate only [CPO]), laterality, completeness and associated complications/anomalies.ResultsOf 189 patients, 101 (53.4%) were male and 88 (46.6%) were female. The median age at presentation was 4 months. CL ± A was most common (38.6%, <i>n</i> = 73), followed by CLP (34.9%, <i>n</i> = 66) and CPO (26.5%, <i>n</i> = 50). Unilateral clefts (79.5%) and left-sided defects (60.3%) predominated. Feeding difficulties were the most frequent complication (59.1% of 93 patients with complications). Associated anomalies were present in 36 patients (19.0%).ConclusionsOFCs present a significant burden at this tertiary centre. Determining patterns of cleft phenotypes informs surgical timing and type, highlighting the need for policies to allocate resources for multidisciplinary care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496582"},"PeriodicalIF":1.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168881","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":"Cleft Palate Surgery: Evolving Surgical Techniques and Reconstructive Principles for Oronasal Fistula and Velopharyngeal Dysfunction: A Narrative Review.","authors":"Rogelio Martínez-Wagner, Kenzo Alejandro Fukumoto-Inukai, María Bejar-Chapa, Miguel Ángel Domínguez-Varela, Javier Andrés Meza-Hernández, Sergio Heinar Rodríguez-Sosa, Luis Alejandro Rodríguez-Corpus, Cindy A Hernández-Cárdenas, Luis Eduardo Salinas-Ruiz, José Emiliano González-Flores, Christopher De Jesús-Fernández, Hernando A Vázquez-Sánchez","doi":"10.1177/10556656261495240","DOIUrl":"https://doi.org/10.1177/10556656261495240","url":null,"abstract":"<p><p>BackgroundDespite more than a century of surgical innovation, no single palatoplasty technique has demonstrated consistently superior outcomes across the spectrum of cleft palate phenotypes.ObjectiveThis review examines the historical evolution of cleft palate reconstruction and contemporary evidence relating operative techniques, technical modifications, and reconstructive adjuncts to oronasal fistula (ONF) and velopharyngeal outcomes.MethodsA narrative literature search of PubMed/MEDLINE, Scopus, the Cochrane Library, and Google Scholar (January 1990-March 2026) incorporated original clinical studies, systematic reviews, meta-analyses, and landmark reports, with evidence from primary palatoplasty, symptomatic submucous cleft palate, secondary velopharyngeal surgery, and fistula reconstruction considered according to clinical setting.ResultsAcross a heterogeneous evidence base, favorable outcomes were associated with restoration of the levator sling, tension-minimized multilayer closure, preservation of vascularity, adequate tissue recruitment, and adaptation of reconstruction to cleft morphology. The independent contribution of these principles remains uncertain because the evidence is predominantly observational and heterogeneous.ConclusionsSuccessive palatoplasty techniques therefore appear to represent different strategies for addressing shared reconstructive constraints rather than competing solutions with uniformly superior outcomes. This updated synthesis integrates established reconstructive principles with contemporary evidence on ONF, velopharyngeal outcomes, cleft morphology, and tissue deficiency to provide an outcome-oriented framework for individualized cleft palate reconstruction.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261495240"},"PeriodicalIF":1.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170576","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}