Cleft Palate-Craniofacial Journal最新文献

{"title":"Virtual Reality Simulation of Airway Management Post-Cleft Palate Surgery: A Model for Sustainable and Equitable Education.","authors":"Alexandra N Verzella, Allison L Diaz, Matteo Laspro, Andre Alcon, Jill Schechter, Aaron Oliker, Anne Arnold, Roberto L Flores","doi":"10.1177/10556656241241128","DOIUrl":"10.1177/10556656241241128","url":null,"abstract":"<p><p>BackgroundThe effectiveness of virtual-reality (VR) simulation-based training in cleft surgery has not been tested. The purpose of this study was to evaluate learners' acceptance of VR simulation in airway management of a pediatric patient post-cleft palate repair.MethodsThis VR simulation was developed through collaboration between BioDigital and Smile Train. 26 medical students from a single institution completed 10 min of standardized VR training and 5 min of standardized discussion about airway management post-cleft palate repair. They spent 4-8 min in the VR simulation with guidance from a cleft surgery expert. Participants completed pre- and post-surveys evaluating confidence in using VR as an educational tool, understanding of airway management, and opinions on VR in surgical education. Satisfaction was evaluated using a modified Student Evaluation of Educational Quality questionnaire and scored on a 5-point Likert scale. Wilcoxon signed-rank tests were performed to evaluate responses.ResultsThere was a significant increase in respondents' confidence using VR as an educational tool and understanding of airway management post-cleft palate repair after the simulation (<i>P</i> < .001). Respondents' opinions on incorporating VR in surgical education started high and did not change significantly post-simulation. Participants were satisfied with VR-based simulation and reported it was stimulating (4.31 ± 0.88), increased interest (3.77 ± 1.21), enhanced learning (4.12 ± 1.05), was clear (4.15 ± 0.97), was effective in teaching (4.08 ± 0.81), and would recommend the simulation (4.2 ± 1.04).ConclusionVR-based simulation can significantly increase learners' confidence and skills in airway management post-cleft palate repair. Learners find VR to be effective and recommend its incorporation in surgical education.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1156-1163"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307599","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":"Risk Factors for Otitis Media in Pediatric Patients With Cleft Lip and/or Cleft Palate: Systematic Review and Meta-analysis.","authors":"Arshbir Aulakh, Arshroop Khaira, Murad Husein, Julie E Strychowsky, M Elise Graham","doi":"10.1177/10556656251352708","DOIUrl":"https://doi.org/10.1177/10556656251352708","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate risk factors for otitis media (OM) in children with cleft lip and/or palate (CL/P).</p><p><strong>Design: </strong>Systematic review of MEDLINE, Embase, Cochrane, CINAHL, and Web of Science using PRISMA guidelines. Meta-analysis was performed using RevMan5.4.1.</p><p><strong>Setting: </strong>Eligible studies included cross-sectional, retrospective, and prospective studies.</p><p><strong>Patients/participants: </strong>Pediatric patients with CL/P who develop OM.</p><p><strong>Interventions: </strong>OM risk factors including age, gender, and cleft type and size.</p><p><strong>Main outcome measure(s): </strong>Incidence of OM.</p><p><strong>Results: </strong>Eighteen studies involving 2272 children with CL/P were included. Pooled results showed no statistically significant difference in OM incidence between male and female children with CL/P (OR: 1.16; 95% CI: 0.80-1.60; <i>P</i> = .44). There was no significant difference in OM incidence between patients aged 2 years and below and those aged above 2 years (OR: 2.14; 95% CI: 0.33-13.83; <i>P</i> = .42). Cleft lip and palate (CLP) patients demonstrated significantly higher incidences of OM than cleft palate (CP) (OR: 1.58; 95% CI: 1.09-2.29; <i>P</i> = .02) and cleft lip (CL) patients (OR: 8.26; 95% CI: 2.21-30.90; <i>P</i> = .002). CP-only patients also demonstrated significantly higher OM incidences than CL-only patients (OR: 22.30; 95% CI: 8.40-59.21; <i>P</i> < .00001). Moreover, CPs classified as Veau III and IV showed higher OM incidences than those classified as Veau I and II (OR: 0.32; 95% CI: 0.18-0.58; <i>P</i> = .0001 and OR: 0.51; 95% CI: 0.33-0.77; <i>P</i> = .001, respectively).</p><p><strong>Conclusion: </strong>CLP and CP alone are significant risk factors for developing OM in children, but not age and sex.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251352708"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530707","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":"Indiacran: An Inter-Center Study of Nasolabial Esthetics Outcomes in Patients With Repaired Complete Unilateral Cleft Lip and Palate.","authors":"Puneet Batra, Garima Arora, Abhinav Raj Gupta, Abhishek Bhamre, Amit Agarwal, Asif Masood, Hemwati Nandan, Himanshu Trivedi, Isha Jain, Jaideep Singh Chauhan, Kamlesh Singh, Krishnamurthy Bonanthaya, Nitin Bhola, Pallavi Daigwane, Pritham N Shetty, Ravi Kumar Mahajan, Samiksha Chopra, Shibani Das, Shruti Bijapur, Srinivas Gosla Reddy, Subodh Kumar Singh, Sukhdeep Singh Kahlon, S C Sood, Suryakant Das, Tarun Chaudhary, Virag Bhatia","doi":"10.1177/10556656251352604","DOIUrl":"https://doi.org/10.1177/10556656251352604","url":null,"abstract":"<p><p>ObjectiveTo evaluate the nasolabial aesthetic outcomes in patients aged 8 to 14 with nonsyndromic, repaired complete unilateral cleft lip and palate.DesignRetrospective study.SettingTen Comprehensive Cleft Care Centers (Smile Train) across India.SubjectsA sample of 400 patients treated at the 10 centers (40 each) with repaired complete unilateral cleft lip and palate were included.MethodsAfter obtaining ethical approval, frontal and profile photographs of patients before any orthodontic treatment were scanned, cropped, and coded to show the nose and upper lip. Using the coded photographs, 4 nasolabial features for aesthetics (ie, nasal symmetry, nasal form, vermilion border, and nasolabial profile) were rated by 3 examiners using Asher McDade's rating system. Interrater and intrarater reliabilities were determined using Cronbach's alpha values. Mean ratings of all centers were compared using a one-way analysis of variance.ResultsThe total nasolabial scores of various centers were significantly varied, ranging from 2.89 to 3.47. The best nasolabial esthetics score for Center A. Cronbach's alpha values for interrater reliability are as follows: nasal form: 0.876, nasal symmetry: 0.742, vermillion border: 0.799, and nasolabial profile: 0.844, demonstrating good to excellent reliability.ConclusionAlthough these centers used different protocols, the nasolabial esthetics outcomes were good to fair for all 10 cleft care centers. The total score of nasolabial esthetics amongst centers is significantly different.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251352604"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530703","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":"Impact of Intraoperative Transfusion Volume on Length of Stay in Synostosis Repair.","authors":"Alexandra Giantini Larsen, Abhinav Pandey, Natasha Kharas, Michelle Buontempo, Jason Adelhoefer, Makayla Kochheiser, Alyssa B Valenti, Thomas A Imahiyerobo, Caitlin E Hoffman","doi":"10.1177/10556656251352733","DOIUrl":"https://doi.org/10.1177/10556656251352733","url":null,"abstract":"<p><p>ObjectiveTo examine the impact of intraoperative packed red blood cell (pRBC) transfusion status and volume on the length of stay (LOS) for patients undergoing open or endoscopic craniosynostosis repair.DesignRetrospective consecutive case series for craniosynostosis repair.SettingNewYork-Presbyterian/Weill Cornell Medicine (WCM) 2016 to 2024.Patients/ParticipantsA total of 232 patients undergoing craniosynostosis repair were included. Cases without vault remodeling or those considered non-standard/complex were excluded.InterventionEndoscopic or open craniosynostosis repair.Main Outcome MeasuresLOS, complications.ResultsOf 232 cases, 109 (47.0%) were treated with open cranial vault remodeling, and 123 (53.0%) underwent endoscopic suturectomy. Open cases had significantly higher blood loss, pRBC transfusion volume, TXA transfusion status and volume, and longer LOS (4.1 ± 4.0 days vs 1.2 ± 0.7 days). The transfusion rate was 58.7% in open cases versus 4.1% in endoscopic cases, with mean volumes of 27.9 ± 19.5 cc/kg and 17.3 ± 11.5 cc/kg, respectively. While transfusion status did not affect LOS in either cohort, multivariate linear regression, accounting for variables such as age, gender, weight, surgical approach, and case duration, found that transfusion volume independently predicted LOS. Patients with multiple sutural fusion generally had longer LOS than patients with singular sutural fusion.ConclusionsMinimizing transfusion volumes could reduce LOS, emphasizing the need for improved surgical planning and anesthetic strategies to reduce transfusion burden. This study's retrospective, single-center design limits its generalizability, necessitating prospective trials to standardize transfusion criteria and assess the impact of preoperative hemoglobin and hematocrit's role in outcomes.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251352733"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530702","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":"Quantifying Sagittal Craniosynostosis Severity: A Machine Learning Approach With CranioRate.","authors":"Wenzheng Tao, Tobi J Somorin, Janina Kueper, Angel Dixon, Nicolas Kass, Nawazish Khan, Krithika Iyer, Jake Wagoner, Ashley Rogers, Ross Whitaker, Shireen Elhabian, Jesse A Goldstein","doi":"10.1177/10556656251347366","DOIUrl":"https://doi.org/10.1177/10556656251347366","url":null,"abstract":"<p><p>ObjectiveTo develop and validate machine learning (ML) models for objective and comprehensive quantification of sagittal craniosynostosis (SCS) severity, enhancing clinical assessment, management, and research.DesignA cross-sectional study that combined the analysis of computed tomography (CT) scans and expert ratings.SettingThe study was conducted at a children's hospital and a major computer imaging institution. Our survey collected expert ratings from participating surgeons.ParticipantsThe study included 195 patients with nonsyndromic SCS, 221 patients with nonsyndromic metopic craniosynostosis (CS), and 178 age-matched controls. Fifty-four craniofacial surgeons participated in rating 20 patients head CT scans.InterventionsComputed tomography scans for cranial morphology assessment and a radiographic diagnosis of nonsyndromic SCS.Main OutcomesAccuracy of the proposed Sagittal Severity Score (SSS) in predicting expert ratings compared to cephalic index (CI). Secondary outcomes compared Likert ratings with SCS status, the predictive power of skull-based versus skin-based landmarks, and assessments of an unsupervised ML model, the Cranial Morphology Deviation (CMD), as an alternative without ratings.ResultsThe SSS achieved significantly higher accuracy in predicting expert responses than CI (<i>P</i> < .05). Likert ratings outperformed SCS status in supervising ML models to quantify within-group variations. Skin-based landmarks demonstrated equivalent predictive power as skull landmarks (<i>P</i> < .05, threshold 0.02). The CMD demonstrated a strong correlation with the SSS (Pearson coefficient: 0.92, Spearman coefficient: 0.90, <i>P</i> < .01).ConclusionsThe SSS and CMD can provide accurate, consistent, and comprehensive quantification of SCS severity. Implementing these data-driven ML models can significantly advance CS care through standardized assessments, enhanced precision, and informed surgical planning.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251347366"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508997","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 Insurance Coverage of Cleft Lip and Palate: A Comparative Analysis of State Healthcare Policies and Legal Frameworks.","authors":"Yasmine Ibrahim, Sumun Khetpal, Wayne Ozaki","doi":"10.1177/10556656251351437","DOIUrl":"https://doi.org/10.1177/10556656251351437","url":null,"abstract":"<p><p>Nonsyndromic cleft lip with or without cleft palate (CL/P) is a prevalent congenital anomaly worldwide that poses significant health challenges. Currently, the United States lacks a unified approach to CL/P coverage. This article explores the U.S. medical-legal framework surrounding CL/P, identified via the PubMed, Google Scholar, Lexis, and Westlaw databases. It examines the Affordable Care Act, the Health Insurance Portability and Accountability Act, and state-level variations in CL/P coverage. The findings suggest a need for legal reform to ensure equitable access for patients with CL/P across the United States.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351437"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study of the Cleft Surgical Workforce in Bolivia.","authors":"Maria Fernanda Tapia, Sonia Treminio, Karel-Bart Celie, Atenas Bustamante, Jonathan Diaz, Allyn Auslander, Billy Magee, Carlos Dorado","doi":"10.1177/10556656251351447","DOIUrl":"https://doi.org/10.1177/10556656251351447","url":null,"abstract":"<p><strong>Objective: </strong>To assess the number of cleft surgeons registered with the Bolivian Society of Plastic Surgery and their desire for further cleft training.</p><p><strong>Design: </strong>An electronic survey distributed through the Bolivian Society of Plastic Surgery.</p><p><strong>Participants: </strong>Eighty-three Bolivian plastic surgeons.</p><p><strong>Results: </strong>Residency training occurred most in Argentina (39.2%), Brazil (31.6%), and Mexico (20.2%), and 29 (35.8%) surgeons reported practicing cleft surgery during their training. The majority (51.7%) of cleft surgeons reported doing cleft work in mission-based settings. No significant association was found between cleft and noncleft surgeon exposure to cleft surgery during training (<i>P</i> = .292) and between the proportion of cleft and noncleft surgeons that were interested in further cleft training (<i>P</i> = .196).</p><p><strong>Conclusions: </strong>We found a board-certified plastic surgery cleft workforce of about 1 per 400 000 inhabitants in Bolivia. The majority reported adequate exposure to cleft care during residency. Both cleft and noncleft surgeons are interested in further cleft training.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351447"},"PeriodicalIF":1.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498968","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":"Bilateral Islanded Propeller Mucoperiosteal Flap Closure: A New Approach to Wide Cleft Palates.","authors":"Sanjay K Giri, Akanksha Rajpoot, Santanu Suba, Priyanka Pant, Vishnu Swaroop Reddy","doi":"10.1177/10556656251351436","DOIUrl":"https://doi.org/10.1177/10556656251351436","url":null,"abstract":"<p><p>ObjectiveTo assess the effectiveness of a novel surgical technique, the bilateral islanded propeller mucoperiosteal flap closure, in managing wide cleft palates while integrating established surgical methods.DesignThis study included six pediatric patients with wide cleft palate who underwent surgery using this novel technique, performed by the senior author between 2022 and 2023 at a center in Eastern India. Patients were monitored for two years to evaluate surgical site-related complications and speech outcomes through both subjective and objective assessments.Main Outcome MeasureTo determine the reliability of this technique in preventing postoperative fistula formation while promoting optimal speech outcomes.ResultsSix pediatric patients underwent corrective surgery for wide cleft palate between the ages of 6 and 12 months. No postoperative complications, such as bleeding, wound dehiscence, hanging palate, or flap necrosis, were observed either immediately after surgery or at the three-week follow-up. At the two-year follow-up, there were no signs of fistula formation at the junction of the hard and soft palate or nasal regurgitation during feeding. Speech function was assessed at regular intervals using classical lateral radiographs at rest and during speech. All patients demonstrated unrestricted soft palate motion with minimal scarring.ConclusionThe Bilateral Islanded Propeller Mucoperiosteal Flap Closure is an innovative and adaptable technique for addressing wide palatal defects. It simplifies surgical management, minimizes scarring, and enhances soft palate length and width. When performed at the appropriate stage, this method effectively preserves speech function.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351436"},"PeriodicalIF":1.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486775","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 and Palate Repairs in a Patient With Epidermolysis Bullosa Simplex.","authors":"William Delahoussaye, Zachary A Stern-Buchbinder, Daniel Yoo, Leslie M Slowikowski, India M Hill, Mohamad Masoumy, Gregory K Fulton","doi":"10.1177/10556656251351775","DOIUrl":"https://doi.org/10.1177/10556656251351775","url":null,"abstract":"<p><p>Epidermolysis bullosa simplex (EBS) is a rare congenital disorder that presents with blistering of the skin from minimal shearing or pulling, making surgical care complex in terms of preventative measures and management. Literature is limited regarding cleft care in this unique patient population. We present a case report outlining a multidisciplinary cleft treatment plan with a focus on communication with the patient's family. Cleft lip and palate repair was performed using standard techniques and timing without complication, demonstrating that cleft lip and palate repairs can safely be performed in a patient with EBS.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351775"},"PeriodicalIF":1.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486776","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":"Complex Craniofacial Challenges: A Case Series of Tessier Clefts 14, 10, 7, and 4.","authors":"Kabita Kalita, Rishi Kumar Gupta, Poresh Baruah, Jyotirmay Baishya","doi":"10.1177/10556656251351097","DOIUrl":"https://doi.org/10.1177/10556656251351097","url":null,"abstract":"<p><p>Craniofacial clefts are very rare congenital anomalies with an incidence of around 1.4 to 4.85 per 100,000 live-births. Our hospital managed four unique cases of Tessier's cleft between 2022 and 2024. They comprise a patient with Tessier No. 14 cleft and a fronto-nasal-ethmoidal meningoencephalocele, second patient with Tessier No. 10 and 4 clefts and coloboma over the upper eyelids, third patient with Tessier No. 7 cleft and macrostomia, and the fourth patient with Tessier No. 14 cleft and hypertelorism. Our series emphasizes the importance of individualized surgical planning, multidisciplinary approach, and parental requirements in the treatment of such craniofacial anomalies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251351097"},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477494","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}