Cleft Palate-Craniofacial Journal最新文献

{"title":"How Much Pain Medication Do Patients Require After Posterior Iliac Crest Bone Graft to the Alveolar Cleft?","authors":"Andrew J Deek, Snigdha Jindal, Kate Bridges, Alistair Varidel, Bonnie L Padwa, Cory M Resnick","doi":"10.1177/10556656241309157","DOIUrl":"https://doi.org/10.1177/10556656241309157","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to quantify analgesic use following alveolar cleft bone grafting (ABG) utilizing a posterior iliac crest (PIC) donor site.</p><p><strong>Design: </strong>This is a prospective cohort study of consecutive patients that underwent ABG with PIC in a 10 month period from November 2022 to September 2023.</p><p><strong>Setting: </strong>Tertiary care free-standing pediatric hospital.</p><p><strong>Participants: </strong>Patients with cleft lip and alveolus with or without cleft of the secondary palate undergoing alveolar bone graft with cancellous marrow from the PIC.</p><p><strong>Interventions: </strong>All patients underwent ABG and recorded analgesic use afterwards.</p><p><strong>Main outcome measure: </strong>The main outcome variable was total pain medication utilization during the first 10 postoperative days (PODs).</p><p><strong>Results: </strong>22 subjects (72.7% male, 54.5% Caucasian 72.7% unilateral and 27.3% bilateral clefts) recorded pain medication use. Total duration of analgesic use (any type) was 3.86 ± 1.7 postoperative days. 10 subjects (45.5%) did not use opioid medication postoperatively. The remaining 12 subjects (54.5%) used a median of 12 (0, 19) morphine milli-equivalents (MME), equal to 1.6 (0, 2.53) doses of 5 mg oxycodone. An average of 9.9 ± 5.6 doses of acetaminophen and 9.1 ± 4.7 doses of a non-steroidal anti-inflammatory drug (NSAID) were administered. No subject used opioids after POD3. Patients with unilateral clefts used more acetaminophen (<i>p</i> = 0.02); otherwise, there were no significant differences in outcomes based on any predictor variable (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Analgesic requirements after ABG with PIC were minimal, with nearly half of patients taking no postoperative opioids. As such, judicious opioid prescribing is prudent.  .</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241309157"},"PeriodicalIF":1.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972977","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":"Benefit Finding in Craniofacial Conditions: A Qualitative Analysis of Patient and Parent Perspectives.","authors":"Alyssa K Choi, Megan Korhummel, Caitlyn C Belza, Josseline Herrera Eguizabal, Sydney Olfus, Chelsea S Rapoport, Jessica Blum, Viridiana J Tapia, Julia H Drizin, Amanda Gosman, Vanessa L Malcarne","doi":"10.1177/10556656241305889","DOIUrl":"https://doi.org/10.1177/10556656241305889","url":null,"abstract":"<p><strong>Objective: </strong>Craniofacial conditions (CFCs) can be associated with adverse effects on quality of life (QoL). However, few studies have examined perceived benefits related to CFCs. This study described perceived benefits in an international sample of children and adolescents with CFCs and their parents.</p><p><strong>Design: </strong>Semistructured qualitative interviews were completed in English or Spanish as part of a larger study. Deductive content analysis described and quantified perceived benefits associated with CFCs.</p><p><strong>Setting: </strong>Interviews were during standard visits at Rady Children's Hospital-San Diego in the USA and the Hospital Infantil de las Californias in Tijuana, Baja California, Mexico.</p><p><strong>Participants: </strong>Patients were ages 7 to 20 years (<i>n</i> = 32) with CFCs (cleft lip and/or palate, craniosynostosis, microtia, hemifacial microsomia, dermatologic conditions/neurovascular malformations, and trauma-acquired CFC), and parents (<i>n</i> = 71) had children ages 5 months to 23 years with CFCs. Of the total sample, there were 14 patient-parent dyads.</p><p><strong>Results: </strong>A total of 230 benefits were identified. Of the patients (47%) and parents (73%) who identified at least 1 benefit, themes included personal growth (40%), understanding or helping others facing challenges (25%), social relationships (23%), spiritual or religious beliefs (4%), philanthropy (4%), material or external gains (3%), and personal health (1%).</p><p><strong>Conclusions: </strong>Patients with CFCs and their parents report multiple positive effects of CFCs on their QoL. These findings indicate that benefit finding is a common experience in this population and may be leveraged by clinicians to help promote positive adjustment to living with a CFC.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241305889"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957580","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":"Design, Development, and Evaluation of a 3D-Printed Buccal Myomucosal Flap Simulator.","authors":"Mitchell D Cin, Zahra Nourmohammadi, Usama Hamdan, David A Zopf","doi":"10.1177/10556656241311044","DOIUrl":"https://doi.org/10.1177/10556656241311044","url":null,"abstract":"<p><strong>Objective: </strong>Buccal myomucosal flap procedures have become a critical tool in the armamentarium of the cleft surgeon. Mastering this technique is complex and providing sufficient training opportunities presents significant challenges. Our study details the design, development, and evaluation of a low-cost, high-fidelity buccal myomucosal flap surgical simulator. Our goal is to establish a reliable teaching tool for early learners, validated through craniofacial surgeon assessment.</p><p><strong>Design: </strong>The simulator comprises of an anatomical model and a stand created using computer-aided design software. Hard tissues were 3D-printed, while soft tissues were cast in silicone. The model underwent review by craniofacial surgeons utilizing a 1 to 5 Likert scale across six evaluation domains.</p><p><strong>Setting: </strong>In-person simulated dissection session.</p><p><strong>Patients/participants: </strong>Sixteen craniofacial surgery providers from various subspecialties.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measure: </strong>Anonymized survey responses.</p><p><strong>Results: </strong>The simulator received fair to high scores across all evaluation domains, notably 4.31 as a training tool, 3.77 as a competency evaluation tool, 3.92 as a rehearsal tool, and 3.93 in relevance to practice.</p><p><strong>Conclusions: </strong>The validated buccal myomucosal flap simulator theoretically enables the acquisition of surgical skills in a zero-risk simulated environment. Plans involve integration into a structured curriculum with diverse participants. Continued iteration and adoption hold the promise of significantly enhancing access to training for competency of cleft and craniofacial procedures.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241311044"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957582","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":"Mandibular Distraction Osteogenesis vs. Tracheostomy in the Management of Pierre Robin Sequence: A Systematic Review and Meta-Analysis.","authors":"Indri Lakhsmi Putri, Kusuma Islami, Imaniar Fitri Aisyah, Rachmaniar Pramanasari, Citrawati Dyah Kencono Wungu","doi":"10.1177/10556656241311549","DOIUrl":"https://doi.org/10.1177/10556656241311549","url":null,"abstract":"<p><strong>Objective: </strong>This study compares mandibular distraction osteogenesis (MDO) and tracheostomy in managing severe airway obstruction in patients with the Pierre Robin sequence (PRS).</p><p><strong>Design: </strong>A systematic review and meta-analysis following PRISMA guidelines was performed. Literature searches were conducted across PubMed, ScienceDirect, Cochrane Library, Scopus, E.B.S.C.O., and Web of Science, including grey literature, covering studies until May 30, 2024. Study quality was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Patients: </strong>patients with Pierre Robin Sequence.</p><p><strong>Interventions: </strong>Mandibular distraction osteogenesis (MDO) and tracheostomy.</p><p><strong>Main outcome measures: </strong>Primary outcomes included airway management (tracheostomy avoidance for MDO, decannulation for tracheostomy) and feeding outcomes (G-tube placement). Secondary outcomes were hospital length of stay and associated costs.</p><p><strong>Results: </strong>Thirteen studies were included. MDO and the MDO-first approach demonstrated significantly better airway outcomes (OR = 10.72, 95% CI = 1.97-58.44, p = 0.006; OR = 4.51, 95% CI = 2.61-7.79, p < 0.00001). MDO also reduced the need for G-tube placement (OR = 0.09, 95% CI = 0.04-0.18, p < 0.00001) and lowered hospital costs (MD = -47.90 thousand USD, 95% CI = -59.93 to -35.87, p < 0.0001). A shorter hospital stay was observed but was not statistically significant.</p><p><strong>Conclusions: </strong>MDO offers better airway outcomes, lower G-tube placement rates, and reduced costs, making it a preferred option. Larger studies within the same syndromic status are needed to minimize confounding factors and validate these findings.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241311549"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957604","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":"Prenatal Diagnosis of Nonsyndromic Craniosynostosis: A Scoping Review.","authors":"Gwendolyn E Daly, Alexa Stefanko, Catherine Henning, Lisa Crupi, Lori K Howell, Erik M Wolfswinkel","doi":"10.1177/10556656241308352","DOIUrl":"https://doi.org/10.1177/10556656241308352","url":null,"abstract":"<p><p>Craniosynostosis is rarely diagnosed in utero. Prenatal diagnosis has the potential to improve patient outcomes and streamline care, however, and is becoming more feasible as technology improves. The objective of this study is to examine existing literature on prenatal diagnosis of nonsyndromic craniosynostosis.</p><p><p>In accordance with PRISMA guidelines, Embase, Cochrane, and PubMed were searched for articles discussing prenatal diagnosis of nonsyndromic craniosynostosis via imaging studies. Studies that exclusively examined syndromic craniosynostosis were excluded.</p><p><p>Diagnostic criteria for prenatal diagnosis of craniosynostosis.</p><p><p>The search identified 2129 articles. And 12 articles met inclusion criteria and were included in the final analysis. Ten of 12 included studies (83.3%) utilized biometric data (biparietal and occipitofrontal diameter, cranial index) to analyze fetal head shape. Two of 12 studies (16.7%) utilized specific ultrasonic markers to identify craniosynostosis including a \"brain shadowing sign.\" One study (8.3%) created a systematic quantitative screening methodology with formal shape analysis for identification of sagittal synostosis. In all included studies, identification of craniosynostosis was possible in the second or third trimesters.</p><p><p>Prenatal diagnosis of craniosynostosis is feasible and has the potential to improve patient outcomes. Creation of screening protocols and standardized metrics for sonographic diagnosis are important next steps in craniosynostosis care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241308352"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957658","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":"Multidisciplinary Oral Rehabilitation of Complex Frontonasal Dysplasia: A Case Report.","authors":"Roberta Costa E Silva, Cristiano Tonello, José Carlos da Cunha Bastos, Regina Magrini Guedes de Azevedo, Roseli Maria Zechi-Ceide, Daniela Garib, Felicia Miranda, Beatriz Martins de Andrade, José Fernando Castanha Henriques, Adriano Porto Peixoto","doi":"10.1177/10556656241307738","DOIUrl":"10.1177/10556656241307738","url":null,"abstract":"<p><p>This case report presents the multidisciplinary treatment of a male patient with a complex form of frontonasal dysplasia who presented with a 0 to 14 facial cleft, mild hypertelorism, absence of the nasal medial process of the nose, and frontonasal encephalocele. Cranial and plastic surgeries were performed to correct hypertelorism and improve the esthetic appearance of the frontonasal region. In the permanent dentition, the patient presented a Class II, division 1 malocclusion with severe maxillary constriction and bilateral posterior crossbite. Comprehensive orthodontic treatment started at 12 years of age and included rapid maxillary expansion followed by fixed appliance. Orthognathic surgery was performed at 21 years of age involving a forward movement of both maxilla and mandible. After debonding, veneers were made in maxillary anterior teeth to improve tooth shape and Bolton discrepancies. An improvement in facial esthetics and an adequate final occlusion were achieved. Multidisciplinary treatment was essential for morphological rehabilitation and social inclusion in patients with rare craniofacial anomalies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241307738"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957656","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":"Primary Rhinoplasty for Unilateral Cleft Lip: A Long-Term Cohort Assessment of Aesthetic and Anthropometric Outcomes.","authors":"Jinggang J Ng, Manisha Banala, Jonathan H Sussman, Benjamin B Massenburg, Meagan Wu, Dominic J Romeo, Oksana A Jackson, David W Low, Jesse A Taylor, Jordan W Swanson","doi":"10.1177/10556656241309810","DOIUrl":"https://doi.org/10.1177/10556656241309810","url":null,"abstract":"<p><p>The decision to undertake rhinoplasty maneuvers during cleft lip repair remains controversial. Little data compare long-term outcomes with and without primary rhinoplasty (PR). This study compared nasolabial outcomes in cohorts with unilateral cleft lip (UCL) treated with and without PR at the Children's Hospital of Philadelphia using standardized aesthetic and anthropometric assessments.</p><p><p>Retrospective cohort study.</p><p><p>Tertiary care pediatric hospital.</p><p><p>Patients who underwent lip repair for UCL.</p><p><p>Cleft lip repair with and without PR.</p><p><p>Anthropometric analyses and crowdsourced aesthetic assessments using Americleft nasolabial appearance reference scales and pairwise comparisons.</p><p><p>Among 208 patients, 155 (74.5%) and 53 (25.5%) underwent lip repair with and without PR at 4.5 ± 1.1 months. Primary rhinoplasty (β = 0.345, <i>P</i> = .037) and a lower Cleft Lip Severity Index (β = -0.341, <i>P</i> < .001) predicted superior pairwise rank at 4.9 ± 1.9 years of age. History of PR predicted decreased columellar deviation angle (CDA) (β = -2.375, <i>P</i> = .019) and improved nostril symmetry (β = 0.111, <i>P</i> = .038). Increased columellar-labial angle (<i>r</i> = 0.27, <i>P</i> = .002), improved nostril symmetry (<i>r</i> = -0.23, <i>P</i> = .01), and decreased CDA (<i>r</i> = -0.45, <i>P</i> < .001) correlated with superior ratings. Patients with ˂20 days of postoperative nasal stenting had inferior lateral ratings (2.4 ± 0.6 vs 2.1 ± 0.5, <i>P</i> = .005). Those who underwent surgery at ˂5.3 months had inferior nasal projection (Goode's ratio 0.56 ± 0.09 vs 0.62 ± 0.08, <i>P</i> = .006).</p><p><p>Primary rhinoplasty for UCL offers superior aesthetic results in early childhood by layperson and anthropometric assessments. Specific improved characteristics from PR-CDA and nostril symmetry-most greatly influence layperson perception of nasal appearance. Older age at surgery predicted increased nasal projection, while prolonged nasal stenting predicted superior profile appearance.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241309810"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957674","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":"Unveiling Oral Health Differences: Gingival Health and Hygiene in Children With and Without Cleft Lip and Palate.","authors":"Guida Paola Genovez, Matheus Souza de Campos Costa, Lucas José de Azevedo-Silva, Gisele da Silva Dalben, Daniela Gamba Garib, Ana Lúcia Pompéia Fraga de Almeida","doi":"10.1177/10556656241310098","DOIUrl":"https://doi.org/10.1177/10556656241310098","url":null,"abstract":"<p><strong>Objective: </strong>To compare the oral hygiene and gingival health of children with and without cleft lip and palate.</p><p><strong>Design: </strong>Cross-sectional comparative study.</p><p><strong>Setting: </strong>Institutional tertiary referral hospital.</p><p><strong>Patients/participants: </strong>This study was conducted on 108 children aged 6 to 12 years, divided into 3 groups: Group 1 = children with cleft lip and alveolus with or without cleft palate, unilateral or bilateral (<i>n</i> = 36, 22 boys and 14 girls, aged 8, 39 ± 1.61 years), Group 2 = children with isolated cleft palate (<i>n</i> = 36, 8 boys and 28 girls, 8.11 ± 1.88 years); and Group 3 = children without clefts (<i>n</i> = 36, 18 boys and 18 girls, 8.53 ± 1.33 years).</p><p><strong>Main outcome measures: </strong>The clinical parameters evaluated were Gingival Index (GI) and Patient Hygiene Performance (PHP) Index. analysis of variance and Kruskal-Wallis tests were used to evaluate intergroup differences. Correlations between the variables age, PHP Index and GI were assessed by the Spearman correlation (<i>P</i> < .05).</p><p><strong>Results: </strong>The results demonstrated no statistically significant difference between the three groups for the PHP index (<i>P</i> = .126). There was also no intergroup difference for GI (<i>P</i> = .418).</p><p><strong>Conclusions: </strong>No difference for the gingival status was observed between children with cleft lip and palate and with isolated cleft palate. Children with oral clefts present adequate gingival status compared to noncleft children.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241310098"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957678","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":"Evaluation of the Effect of Unilateral Cleft Palate on Piriform Aperture Dimensions.","authors":"Emre Aytuğar, Fahrettin Kalabalık, Emre Haylaz, Muhammed Şamil Özkan, Burçin Akan","doi":"10.1177/10556656241311056","DOIUrl":"https://doi.org/10.1177/10556656241311056","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present research was to assess and compare the piriform aperture dimensions of subjects with a unilateral cleft lip and palate (UCLP) and those of a control group using cone-beam computed tomography (CBCT).</p><p><strong>Design: </strong>CBCT data of 40 subjects with a complete UCLP (28 males and 12 females, with a mean age of 17.21 ± 5.75 years) and 40 CBCT images of age- and <i>sex-matched</i> subjects with no cleft, serving as the control group (28 males, 12 females; mean age, 17.25 ± 5.74 years) were included in the study. The maximal height and width of the piriform aperture as well as nasal bone height were measured and statistically compared between the groups.</p><p><strong>Results: </strong>There were no significant differences in the age and sex distributions between the groups. The mean piriform aperture height was significantly lower in the UCLP group than in the control group, while the mean piriform aperture width was significantly higher in the UCLP group compared to the control group (<i>P</i> < .01). Furthermore, the mean bony nasal height was found to be significantly lower in the UCLP group than in the control group (<i>P</i> < .01).</p><p><strong>Conclusions: </strong>According to the present findings, UCLP is associated with changes in the piriform aperture dimensions due to lower height and higher width values. These structural alterations may contribute to the functional and aesthetic nasal challenges in patients with UCLP.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241311056"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957599","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":"Evaluating the Use of a 3D Exoscope to Improve Ergonomics in Cleft Surgery.","authors":"Kwang Chear Lee, Benjamin Frearson, Bashirat Adedoyin Alagbe, Mohamed Gamal Abdelazim Salem ElSafti, Craig Nightingale, Jane Cooke, Channa Panagamuwa, Kezia Echlin, Khurram Khan","doi":"10.1177/10556656241305229","DOIUrl":"https://doi.org/10.1177/10556656241305229","url":null,"abstract":"<p><p>The aim of this study was to investigate and compare the technical feasibility, ergonomics, and educational value of the 3D exoscope in comparison with traditional and prism loupes in cleft surgery.</p><p><p>A variety of cleft and pharyngeal operations were performed with the VITOM^® 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany), traditional/prism loupes, and microscope. The cervical neck angulation of the operating surgeon was recorded in real-time with an inertia measurement unit system (Mbient, San Francisco, USA) and experiences of the surgeon and assistant were prospectively evaluated with 5-point Likert scales.</p><p><p>National Health Service, England.</p><p><p>Eleven patients were recruited in whom 12 procedures were performed. Two main surgeons, 3 assistant surgeons, and 3 scrub nurses were recruited into the study.</p><p><p>Four procedures were performed with the VITOM^® 3D exoscope, and as the comparison groups, 5 procedures were performed with normal loupes, 3 with prism loupes, and 2 were done in combination with a microscope and analyzed separately.</p><p><p>Neck angle measurements and feedback from surgeons, assistants, and scrub nurses.</p><p><p>The VITOM^® system improved surgeon ergonomics with reduced procedure time in cervical flexion when compared to the other visualization methods (versus loupes, <i>P</i> < .01, and prism, <i>P</i> < .01). The VITOM^® system also scored favorably in terms of image-related fields, ergonomics, and ease of use.</p><p><p>Use of the 3D exoscope in cleft surgery yielded improved experiences for both surgeons, assistants, and nurses in comparison with loupes and microscopes without increasing operating time.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241305229"},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957597","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}