Cleft Palate-Craniofacial Journal最新文献

{"title":"Different Surgical Approaches to the Treatment of Cleft Palate Fistulae as Perceived by Cleft Surgeons.","authors":"Johannes A Smit, Ruben P Houkes, Nadia Lachkar, J Peter W Don Griot, Chantal M A M van der Horst, Raymond W Tse, Ghulam Qadir Fayyaz, Saleigh Adams, Corstiaan C Breugem","doi":"10.1177/10556656241286864","DOIUrl":"https://doi.org/10.1177/10556656241286864","url":null,"abstract":"<p><strong>Objective: </strong>Palatal fistulas after palatoplasty could pose difficulties for both patients and surgeons. Numerous surgical approaches are available to treat palatal fistulas. In this manuscript, we investigate surgical treatment options for palatal fistula repair looking at the different anatomical locations, and we create a summary of surgical approaches to facilitate the decision-making process for palatal fistulae repair.</p><p><strong>Design: </strong>In this cross-sectional survey, nine anonymized patient cases with palatal fistulae that differed in severity and anatomical location were presented to participants from the International Cleft Master Course in Amsterdam about \"Palatal Fistulas\". Participants were invited to participate in this survey. A total of 141 participants reported their preferred surgical treatment options for fistula repair at different anatomical locations.</p><p><strong>Results: </strong>We created different options for fistula treatment, catalogued by fistula location. This overview gives the surgeon possible approaches for each location. If the soft palate is involved, this overview underscores the importance of including velopharyngeal insufficiency management into the fistula repair. For hard palate involvement, our overview lists techniques available for nasal lining repair and for oral lining repair in each region.</p><p><strong>Conclusions: </strong>We provide a comprehensive overview of potential surgical approaches to repair palatal fistulae. This inventory of techniques is grouped per location to support surgeons in their decision-making process when confronted with a palatal fistula.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241286864"},"PeriodicalIF":1.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308892","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":"2,3,7,8-Tetrachlorodibenzo-p-Dioxin Suppresses Mesenchymal Cell Proliferation and Migration Through miR-214-3p in Cleft Palate.","authors":"Xiaobo Dong, Qiang Chen, Haojuan Du, Lin Qiu","doi":"10.1177/10556656241286314","DOIUrl":"https://doi.org/10.1177/10556656241286314","url":null,"abstract":"<p><strong>Objective: </strong>The aetiology of CL/P is complicated, with both genetic and environmental factors. This study aimed to investigate the association between TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) exposure and changes in the expression of miR-214-3p in the context of cleft palate.</p><p><strong>Design: </strong>In this study, we established a fetal mouse cleft palate model using TCDD and differentially expressed miRNAs were analysed by microarray analysis and verified by qRT-PCR. Finally, we demonstrated the effects of TCDD and microRNAs on the proliferation and migration of mesenchymal cells by using CCK8, EDU, Transwell, and wound-healing assays.</p><p><strong>Results: </strong>Our findings revealed significant upregulation of miRNAs such as miR-214-3p, miR-296-5p, and miR-33-5p in the TCDD intervention group, while miRNAs like miR-92a-3p, miR-126a-3p, and miR-411-5p were significantly downregulated. Notably, qRT-PCR testing confirmed a significant difference in miR-214-3P expression. Further investigations involved the overexpression of miR-214-3p, reducing cell proliferation and migration in primary mouse embryonic palatal mesenchymal (MEPM) cells.</p><p><strong>Conclusions: </strong>These results are consistent with the finding that TCDD suppresses palatal mesenchymal cell proliferation and migration through miR-214-3p. In conclusion, miR-214-3p probably plays a role in TCDD-induced cleft palates in mice.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241286314"},"PeriodicalIF":1.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308891","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":"Analysis of the Complications of Mandibular Cortical Bone with/without Particulate Artificial Bone Graft for Alveolar Cleft Reconstruction: A Retrospective Study.","authors":"Xuefei Pang, Xinran Zhao, Jiahui Xie, Ming Cai","doi":"10.1177/10556656241285999","DOIUrl":"https://doi.org/10.1177/10556656241285999","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate postoperative complications in patients who underwent alveolar bone graft surgery using mandibular cortical bone (MCB) with/without particulate artificial bone (PAB).</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Department of Oral and Cranio-Maxillofacial Surgery in the hospital from August 2020 to August 2023.</p><p><strong>Patients: </strong>Patients who underwent alveolar bone graft using MCB were reviewed. They were diagnosed with unilateral or bilateral alveolar cleft, and some of them developed postoperative complications after MCB with/without PAB repair surgery.</p><p><strong>Interventions: </strong>No interventions.</p><p><strong>Main outcome measure(s): </strong>Complications.</p><p><strong>Results: </strong>Complications occurred in 12 of 149 patients who underwent surgery (8.05%). Among these evaluated patients, 10 had surgical site infection, 8 had mucosal dehiscence, 2 had discharge of resorbable plate debris, and 6 had grafted bone necrosis. Patients with bilateral alveolar clefts were more likely to experience complications (P = 0.033).</p><p><strong>Conclusion: </strong>MCB with/without PAB grafting is effective enough for patients to undergo reconstruction of the alveolar process.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241285999"},"PeriodicalIF":1.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299418","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":"Caring for a Child with a Cleft Lip and/or Palate: A Narrative Review.","authors":"Nicola M Stock, Debora Blaso, Matthew Hotton","doi":"10.1177/10556656241280071","DOIUrl":"https://doi.org/10.1177/10556656241280071","url":null,"abstract":"<p><p>Raising a child with healthcare needs places additional demands on caregivers. In 2012, Nelson and colleagues authored a review of 57 papers pertaining to parents' experiences of caring for a child with cleft lip and/or palate (CL/P). Thanks in large part to this review, available literature on this topic has grown considerably. The aim of the present review was to update and critically appraise recent literature, with the wider goal of assessing progress in the field and setting recommendations for future work. All original, peer-reviewed articles pertaining to the psychological adjustment of parents of children with CL/P living in high-income countries (published May 2009 to May 2024) were examined. A total of 126 articles were included. Findings were narratively synthesised according to three salient themes: Emotional Impact; Social Experiences; and Care Delivery. Recent research has built on Nelson et al.'s recommendations, addressing some prior gaps in knowledge. Nonetheless, some areas remained largely unexplored and critical methodological limitations were still evident. Recommendations for clinical practice include: improved informational resources for parents and non-specialist health professionals, regular audit of services in collaboration with parents and families, routine psychological screening for known risk factors and integrated psychological support from diagnosis onward. Recommendations for future research include the design of multicentre, prospective, longitudinal studies with sufficient sample sizes and appropriate control/reference groups, inclusion of families from diverse ethnic and socioeconomic backgrounds, further examination of factors contributing to psychological growth, the development and evaluation of psychological interventions, and cross-condition learning.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241280071"},"PeriodicalIF":1.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156457","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":"Expanding Accessibility in Cleft Care: The Role of Artificial Intelligence in Improving Literacy of Alveolar Bone Grafting Information.","authors":"Artur Manasyan, Sasha Lasky, Marah Jolibois, Tayla Moshal, Idean Roohani, Naikhoba Munabi, Mark M Urata, Jeffrey A Hammoudeh","doi":"10.1177/10556656241281453","DOIUrl":"https://doi.org/10.1177/10556656241281453","url":null,"abstract":"<p><strong>Objective: </strong>The American Medical Association (AMA) recommends patient education materials (PEMs) be written at or below a sixth grade reading level. This study seeks to determine the quality, readability, and content of available alveolar bone grafting (ABG) PEMs and determine if artificial intelligence can improve PEM readability.</p><p><strong>Design: </strong>Review of free online PEMs.</p><p><strong>Setting: </strong>Online ABG PEMs were retrieved from different authoring body types (hospital/academic center, medical society, or private practice).</p><p><strong>Patients, participants: </strong>None.</p><p><strong>Interventions: </strong>Content was assessed by screening PEMs for specific ABG-related topics. Quality was evaluated with the Patient Education Material Assessment Tool (PEMAT), which has measures of understandability and actionability. Open-access readability software (WebFX) determined readability with Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fog Index. PEMs were rewritten with ChatGPT, and readability metrics were reassessed.</p><p><strong>Main outcome measure(s): </strong>Quality, readability, and content of ABG PEMs.</p><p><strong>Results: </strong>34 PEMs were analyzed. Regarding quality, the average PEMAT-understandability score was 67.0 ± 16.2%, almost at the minimum acceptable score of 70.0% (p = 0.281). The average PEMAT-actionability score was low at 33.0 ± 24.1%. Regarding readability, the average Flesch Reading Ease score was 64.6 ± 12.8, categorized as \"standard/plain English.\" The average Flesch-Kincaid Grade Level was 8.0 ± 2.3, significantly higher than AMA recommendations (p < 0.0001). PEM rewriting with ChatGPT improved Flesch-Kincaid Grade Level to 6.1 ± 1.3 (p < 0.0001).</p><p><strong>Conclusions: </strong>Available ABG PEMs are above the recommended reading level, yet ChatGPT can improve PEM readability. Future studies should improve areas of ABG PEMs that are most lacking, such as actionability.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241281453"},"PeriodicalIF":1.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156459","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":"Effect of Age and Gender on Nasalance Across the Lifespan: A Systematic Review.","authors":"Valerie J Pereira, Emily See-Man Ching, Joanna Hoi-Man She, Wilson Shing Yu, Kendy Lau, Michael Chi-Fai Tong, Kathy Yuet-Sheung Lee","doi":"10.1177/10556656241276675","DOIUrl":"https://doi.org/10.1177/10556656241276675","url":null,"abstract":"<p><p>The Nasometer^® is a widely used clinical and research tool with diagnosis and outcome measurement utility. The objective of this study was to systematically examine the effect of age and gender on nasalance across the lifespan.</p><p><p>A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA 2020).</p><p><p>University.</p><p><p>Children, adolescents, adults, and older adults.</p><p><p>Covidence Better Systematic Review Management; Scottish Intercollegiate Guidelines Network Methodology (SIGN) Checklist 3 for risk of bias; Levels of evidence, Oxford Centre for Evidence-Based Medicine Levels of Evidence hierarchy; and effect size calculations using G*Power 3.</p><p><p>Nasalance (%) from the Nasometer™.</p><p><p>50 studies (from N = 1884) were included in the review. All were Level 3 (non-randomized controlled cohort) observational-analytic type studies. Only 10 (20%) of studies met a High Quality (low risk of bias) rating. Effect sizes were moderate for adults versus children (<i>d </i>= 0.717) and adults versus adolescents (<i>d </i>= 0.521) for oral text/passage. Gender differences were clinically significant for adolescent males and females with a moderate effect size (<i>d </i>= 0.545) for oronasal text/passage.</p><p><p>The systematic review provides objective and defined evidence as to the effects of age and gender on nasalance. Separate normative databases are implicated for specific age subgroups across the lifespan and for gender, particularly in adolescence. Review findings are applicable to other clinical groups where acquisition and/or progression occurs in adulthood/older adulthood.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241276675"},"PeriodicalIF":1.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156458","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":"Postoperative Feeding in Cleft Surgery: A Systematic Review.","authors":"Patricia Fuentes, Soroush Farsi, Jose A Garcia, Wassim Najjar, Adam Johnson, Usama Hamdan","doi":"10.1177/10556656241283186","DOIUrl":"10.1177/10556656241283186","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative feeding is crucial for the recovery of children after cleft surgery. The literature outlines diverse feeding methods with varying recommendations on the duration of non-nipple feeding postsurgery. This study aims to explore reported postoperative feeding modalities for infants undergoing primary cleft lip/palate repair, concentrating on their influence on feeding improvement and complication reduction.</p><p><strong>Methods: </strong>PubMed, Cochrane, and Web of Science databases were queried for original English articles without any date restrictions. This review was conducted in accordance with the 2020 PRISMA. The MINORS criteria was used to assess quality of studies.</p><p><strong>Results: </strong>Of 696 abstracts, 9 full-text articles were included, consisting of 459 children with cleft lip (n = 221) & cleft lip/palate (n = 238). Feeding modalities included bottle, breastfeeding, spoon, syringe, and nasogastric tube. Two studies found a significant increase in weight with breastfeeding compared to spoon or cup. Two studies found partial wound dehiscence using spoons, and two studies reported dehiscence using bottles. Post-palatoplasty, two studies showed a decrease in hospital stay in infants breastfed (2.1 & 5.8 days) vs spoon-fed (6 days). Analgesia was reduced in the breastfed group vs spoon/nasogastric tube.</p><p><strong>Conclusion: </strong>This review highlights the importance of postoperative feeding in the recovery of infants with cleft lip/palate. Evidence suggests that breastfeeding may offer advantages in terms of weight gain and reduced hospital stay, while potentially minimizing the need for postoperative analgesia. The limited number of studies and variability in their outcomes underscore the need for further research to establish evidence-based guidelines for postoperative feeding.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241283186"},"PeriodicalIF":1.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156460","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":"Reduction Cranioplasty in Cases of Hydrocephalic Macrocephaly: Pearls and Pitfalls of Computer-Assisted Surgery.","authors":"David L Best, Elizabeth Nyabuto, Kevin C Lee, Renée M Reynolds, Michael R Markiewicz","doi":"10.1177/10556656241271661","DOIUrl":"https://doi.org/10.1177/10556656241271661","url":null,"abstract":"<p><p>Reduction cranioplasty may be indicated to address functional or cosmetic sequelae of hydrocephalic macrocephaly. With the advent of CAD/CAM digital workflow, surgeons can design and fabricate craniotomy guides, templates, and models that allow for precise cranial reconstruction. Although there are several advantages of virtual planning, pre-determined surgical plans may limit intraoperative flexibility, requiring surgeons to troubleshoot errors in pre-operative planning or model design. The purpose of this report is to present a series of cases demonstrating our institution's technique for single-stage reduction cranioplasty using a CAD/CAM workflow. This report will highlight the benefits and challenges associated with a contemporary digital workflow for reduction cranioplasty.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241271661"},"PeriodicalIF":1.1,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157197","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":"The Source of Nasal Rustle (Nasal Turbulence): An Overview of Current Evidence.","authors":"Michael Rollins, Ann Kummer","doi":"10.1177/10556656241278935","DOIUrl":"https://doi.org/10.1177/10556656241278935","url":null,"abstract":"<p><strong>Objective: </strong><i>Nasal rustle</i> (also called <i>nasal turbulence</i>) refers to a loud distracting sound that sometimes occurs with audible nasal emission (ANE) during the production of pressure-sensitive consonants in patients with velopharyngeal insufficiency (VPI). This article examines evidence for two hypotheses of causality: vibration of the soft palate (<i>velar flutter</i>) and periodic motion of mucus above the velopharyngeal port (<i>turbulent mucus</i>).</p><p><strong>Conclusion: </strong>A review of the relevant literature shows inconclusive evidence to support velar flutter as a cause of nasal rustle. In contrast, clinical observations and research involving high-speed nasopharyngoscopy suggest that nasal rustle is the result of turbulent mucus above a small velopharyngeal opening. Therefore, it is our contention that a plausible explanation for nasal rustle is one of turbulent mucus and not velar flutter.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241278935"},"PeriodicalIF":1.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082410","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 Comparison Between Inpatient and Outpatient Surgeries: A Multi-Surgeon Experience.","authors":"Haven M Howell, Laura I Galarza, Laura S Humphries, Ian C Hoppe","doi":"10.1177/10556656241278569","DOIUrl":"https://doi.org/10.1177/10556656241278569","url":null,"abstract":"<p><strong>Objective: </strong>Great variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. This study's aim is to investigate the authors' institutional experience to see if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performed as outpatient.</p><p><strong>Design: </strong>This study reviewed patients who underwent CL repair between 2012 and 2023 at the authors' institution. Data collected included patient demographics, perioperative details, ED visits and readmissions within thirty days of surgery, and complications.</p><p><strong>Results: </strong>One hundred forty-five patients met inclusion measures. When the surgery was performed as outpatient, there was no significant difference in returning to the ED (p = 0.767) or readmission to the hospital (p = 0.447) within thirty days as compared to inpatient surgeries. Outpatients did not have more postoperative complications (p = 0.698). Bilateral cleft lips were more likely to be performed as inpatient (p = 0.001). Inpatients had a lower weight at time of repair (p = 0.033). Patients with a respiratory (p = .006), gastrointestinal (p = 0.003), or hematologic (p = 0.013) comorbidity had a higher readmission rate. Patients were more likely to be readmitted if they had a younger gestational age (p = 0.005).</p><p><strong>Conclusion: </strong>There was no increased return to the ED or readmission for patients undergoing inpatient versus outpatient CL repair. CL repair can be performed safely in an outpatient setting with careful patient selection.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241278569"},"PeriodicalIF":1.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086377","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}