The Cleft Palate-Craniofacial Journal最新文献

Barriers in Accessing Orthodontic Care for Patients with Orofacial Clefts: Insights from a Florida-Based Survey and National Database Analysis. 口面裂患者获得正畸治疗的障碍：来自佛罗里达州调查和全国数据库分析的启示。

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-19 DOI: 10.1177/10556656241284721

Molly F MacIsaac,Joshua M Wright,Nicole K Le,Aleshia J Pringle,Lindsay A Schuster,Andrew B Brown,William L Kochenour,Taryl O Crisp,Jordan N Halsey,S Alex Rottgers

{"title":"Barriers in Accessing Orthodontic Care for Patients with Orofacial Clefts: Insights from a Florida-Based Survey and National Database Analysis.","authors":"Molly F MacIsaac,Joshua M Wright,Nicole K Le,Aleshia J Pringle,Lindsay A Schuster,Andrew B Brown,William L Kochenour,Taryl O Crisp,Jordan N Halsey,S Alex Rottgers","doi":"10.1177/10556656241284721","DOIUrl":"https://doi.org/10.1177/10556656241284721","url":null,"abstract":"OBJECTIVETo assess the barriers to obtaining care for patients with orofacial clefts through a survey of Florida-based orthodontists and families and an analysis of the Pediatric Health Information System (PHIS) database.DESIGNA cross-sectional study utilizing multiple-choice questionnaires completed by Florida orthodontists and caregivers of patients who attended a Florida-based cleft and craniofacial clinic. Additionally, data from the PHIS database were analyzed to investigate national factors affecting the age of alveolar bone grafting (ABG).SETTINGCraniofacial team in Florida.PATIENTS/PARTICIPANTSThe survey included 39 orthodontists (7.1% response rate) and 48 caregivers (41% response rate) The PHIS study included 1182 patients.MAIN OUTCOME MEASURESBarrier to orthodontic care and age of ABG.RESULTSOrthodontic Survey: Among the surveyed orthodontists, 71% treated cleft/craniofacial patients, 37% accepted Medicaid, and 55% provided pro-bono care. Poor reimbursement was identified as the most common barrier (58%). Caregiver Survey: Most patients were insured by Medicaid (67%), with 55% incurring out-of-pocket expenses. PHIS Database: The average age of ABG was 10.3 years (SD = 3.2). Government funding was associated with a 6.0-month delay in ABG (p = 0.047) and residing in non-Medicaid expanded states was linked to a 6.0-month delay (p = 0.023). Post-Medicaid expansion status was also associated with a delay (p = 0.004).CONCLUSIONSAccess to oral care is difficult for patients with OFC. Despite both federal and state mandates, many financial and non-financial barriers still exist in accessing orthodontic care and a majority of patients experience significant out-of-pocket expenses despite statutorily mandated insurance coverage.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"2 1","pages":"10556656241284721"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Sphenoid Sinus Variations in Cleft Lip and Palate Patients: A Comprehensive Cone Beam Computed Tomography Analysis. 唇腭裂患者蝶窦变异的评估：锥形束计算机断层扫描综合分析

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-19 DOI: 10.1177/10556656241286351

Rabia Duman Tepe,Beliz Guray,Elif Akbas Akca,Hulya Cakir Karabas

{"title":"Evaluation of Sphenoid Sinus Variations in Cleft Lip and Palate Patients: A Comprehensive Cone Beam Computed Tomography Analysis.","authors":"Rabia Duman Tepe,Beliz Guray,Elif Akbas Akca,Hulya Cakir Karabas","doi":"10.1177/10556656241286351","DOIUrl":"https://doi.org/10.1177/10556656241286351","url":null,"abstract":"OBJECTIVEThis study aims to compare sphenoid sinus variations between unilateral and bilateral cleft lip and palate (CLP) patients and healthy controls using CBCT images. It is notable for its large sample size and comparison of unilateral and bilateral cleft patients, cleft and noncleft sides, and different age groups.DESIGNRetrospective cohort study.SETTINGUniversity Hospital.PATIENTSCBCT images of 97 CLP patients (76 unilateral, 21 bilateral) and 97 healthy controls were evaluated.Main Outcome Measures: Sphenoid sinus main types, sellar subtypes, clival, and lateral extensions were assessed for all groups.RESULTSA significant increase in the anterior type was observed in both unilateral and bilateral CLP groups. The bilateral CLP group had a higher prevalence of the lesser wing type. In CLP and control groups, lesser wing, combined type, and lateral type were statistically significantly lower under 13 years of age.CONCLUSIONSThe study highlights an elevated prevalence of anterior pneumatization in unilateral and bilateral CLP individuals, emphasizing its significance in surgery planning due to proximity to critical structures like the optic nerve and sphenopalatine artery. The increased prevalence of the lesser wing type in bilateral CLP patients requires extra caution during anterior clinoidectomy. Lower pneumatization rates in CLP patients under 13 suggest their sphenoid sinus development is similar to that of healthy individuals. Understanding these variations is crucial for appropriate surgical planning and avoiding complications during transsphenoidal surgery.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"9 1","pages":"10556656241286351"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 3-Dimensional Morphometric Analysis of 4 Midsagittal Planes for CT Scan Reference Determination in Children with Syndromic Craniosynostosis. 用于确定综合征颅畸形儿童 CT 扫描参考值的 4 个中矢状面的三维形态计量分析。

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-19 DOI: 10.1177/10556656241286309

Lantian Zheng,Norlisah Ramli,Norli Anida Abdullah,Firdaus Hariri

{"title":"A 3-Dimensional Morphometric Analysis of 4 Midsagittal Planes for CT Scan Reference Determination in Children with Syndromic Craniosynostosis.","authors":"Lantian Zheng,Norlisah Ramli,Norli Anida Abdullah,Firdaus Hariri","doi":"10.1177/10556656241286309","DOIUrl":"https://doi.org/10.1177/10556656241286309","url":null,"abstract":"OBJECTIVETo identify the suitable and practical midsagittal plane (MSP) reference for computed tomography (CT) scan skull analysis in patients with syndromic craniosynostosis.DESIGNRetrospective study.SETTINGTertiary referral hospital.PATIENTS AND PARTICIPANTSA total of 19 full skull CT scans of syndromic craniosynostosis patients.METHODSSeven craniofacial landmarks located on the midline and 4 MSPs that was previously published and clinically recognized (Planes: SPBaS, SPNSANS, SPLOrPo and SPZFTP) were constructed from the CT images. The absolute distance of every plane from 7 landmarks were then calculated. These distances were subsequently subjected to statistical analysis.MAIN OUTCOME MEASURE(S)The absolute distance of different MSPs from 7 landmarks.RESULTSThe distances of landmarks measured to SPBaS were the highest, with the most prominent fluctuation. The fluctuation of the SPNSANS, SPLOrPo and SPZFTP had similar direction changes, with the latter being the closest. Pairwise comparisons demonstrated statistical differences (P < .008 using the Bonferroni correction) between the measured distances of A point (M = 0.25, SD = 0.16) and B point (M = 2.21, SD = 1.6) to SPNSANS. There were statistical significances between distances of B point (M = 1.68, SD = 1.07) and CG point (M = 0.55, SD = 0.37) to SPZFTP plane. There was no statistical significance on each landmark to SPLOrPo.CONCLUSIONSThe study demonstrates that SPBaS is not recommended for MSP reference. While SPNSANS should be carefully selected, the application of SPLOrPo and SPZFTP are interchangeable, with the SPZFTP plane slightly exaggerating the mandible deviation relative to the superior and posterior of the midface.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"15 1","pages":"10556656241286309"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vascular Anomalies and Congenital Infiltrating Lipomatosis May Affect Dental Maturation and Development – a Case Control Study 血管异常和先天性浸润性脂肪瘤病可能影响牙齿的成熟和发育--病例对照研究

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-14 DOI: 10.1177/10556656241284761

Sami Leinonen, Pia Vuola, David P Rice, Arja Heliövaara

{"title":"Vascular Anomalies and Congenital Infiltrating Lipomatosis May Affect Dental Maturation and Development – a Case Control Study","authors":"Sami Leinonen, Pia Vuola, David P Rice, Arja Heliövaara","doi":"10.1177/10556656241284761","DOIUrl":"https://doi.org/10.1177/10556656241284761","url":null,"abstract":"ObjectiveVascular anomalies are often associated with hypertrophy and asymmetry of soft tissues and bony structures. The aim of this retrospective cross-sectional radiographic study was to evaluate dental maturation and development in patients with facial vascular anomalies and congenital infiltrating lipomatosis.DesignA sample of 342 patients with different vascular anomalies or congenital infiltrating lipomatosis involving the head and neck area was narrowed down to 31 patients with dental panoramic radiographs taken in the mixed dentition. A control group of 172 age-matched healthy subjects was used. Individual permanent teeth were given a maturation score from 1 to 12 and alveolar eruption stage according to Haavikko et al. 1970. The laterality of the anomaly was noted if applicable. Differences in dental development between affected and unaffected sides were recorded.ResultsThe study data included both syndromic and non-syndromic vascular anomalies as well as congenital infiltrating lipomatosis and segmental odontomaxillary dysplasia. Teeth on the side of the anomaly were more developed and the eruption of teeth was accelerated with canines, premolars and second molars being most affected. Interestingly all the patients with Sturge-Weber syndrome (n = 4) and infiltrating lipomatosis (n = 2) showed accelerated dental maturation of multiple permanent teeth on the side of the anomaly. Hypodontia, dental root resorption and macrodontia were also found.ConclusionsAccelerated development and eruption of permanent teeth unilaterally in patients with vascular anomalies and congenital infiltrating lipomatosis may have a significant impact on the developing occlusion and should be thus followed by an orthodontist.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Involving Experts by Experience in Craniofacial Research 让经验丰富的专家参与颅面研究

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-14 DOI: 10.1177/10556656241283195

Amanda Bates, Kenny Ardouin, Danielle McWilliams

引用次数: 0

Long-Term Surgical Outcomes of Primary Rhinoplasty. 初级鼻整形术的长期手术效果。

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-11 DOI: 10.1177/10556656241272736

Jinggang J Ng,Manisha Banala,Benjamin B Massenburg,Dominic J Romeo,Meagan Wu,Oksana A Jackson,David W Low,Scott P Bartlett,Jordan W Swanson,Jesse A Taylor

{"title":"Long-Term Surgical Outcomes of Primary Rhinoplasty.","authors":"Jinggang J Ng,Manisha Banala,Benjamin B Massenburg,Dominic J Romeo,Meagan Wu,Oksana A Jackson,David W Low,Scott P Bartlett,Jordan W Swanson,Jesse A Taylor","doi":"10.1177/10556656241272736","DOIUrl":"https://doi.org/10.1177/10556656241272736","url":null,"abstract":"OBJECTIVETo examine the impact of primary rhinoplasty on subsequent rhinoplasties for patients with cleft lip nasal deformity.DESIGNRetrospective cohort study.SETTINGTertiary care pediatric hospital.PATIENTS/PARTICIPANTSIndividuals who underwent definitive cleft lip repair at our institution from 2000 to 2006 with a current age of 18 or older.MAIN OUTCOME MEASURESNumber and timing of subsequent rhinoplasties.RESULTSAmong 199 individuals, 94 (47.2%) underwent primary rhinoplasty. Follow-up was 15.0 ± 4.8 years in the PR cohort and 15.0 ± 5.1 years in the NPR cohort (p = 0.993). In bilateral cleft lip, interdomal suture predicted fewer subsequent rhinoplasties (β=-0.310, p = 0.033), while history of primary rhinoplasty predicted greater age at subsequent rhinoplasty (β=1.800, p = 0.040). Among individuals with follow-up beyond age 18, intranasal stenting predicted fewer subsequent rhinoplasties (β=-0.609, p = 0.015). Most underwent subsequent nasal correction aside from 7 (19.4%) and 9 (20.9%) in the PR and NPR cohorts, respectively (p = 0.536). There was no difference in mean subsequent rhinoplasties between cohorts (1.1 ± 0.8 versus 1.3 ± 1.1, p = 0.284). Individuals with complete cleft lip underwent more lifetime rhinoplasties (1.9 ± 1.0 versus 1.2 ± 1.2, p = 0.007).CONCLUSIONSPrimary rhinoplasty with interdomal tip sutures in bilateral cleft lip was associated with fewer subsequent rhinoplasties. Primary rhinoplasty may delay subsequent nasal correction, though most who underwent primary rhinoplasty ultimately required nasal correction later in childhood. Postoperative nasal stenting may provide longer-term nasal benefits and should be considered at time of definitive cleft lip repair.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"52 1","pages":"10556656241272736"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demystifying the Suprazygomatic Maxillary Nerve Block in Paediatric Cleft Palate Surgery 揭开小儿腭裂手术中颌上神经阻滞的神秘面纱

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-11 DOI: 10.1177/10556656241284514

Matthew Fell, Lynn Fenner, Nefer Fallico

{"title":"Demystifying the Suprazygomatic Maxillary Nerve Block in Paediatric Cleft Palate Surgery","authors":"Matthew Fell, Lynn Fenner, Nefer Fallico","doi":"10.1177/10556656241284514","DOIUrl":"https://doi.org/10.1177/10556656241284514","url":null,"abstract":"ObjectiveTo consider the clinical anatomy, safety and effectiveness of the suprazygomatic maxillary nerve block in cleft palate surgery.DesignObservational case series.SettingSingle cleft centre in the United KingdomParticipantsPatients born with a cleft palate (with or without a cleft lip) undergoing palatal surgery between the ages of 9 months and 18 years.InterventionIntroduction of suprazygomatic maxillary nerve (SZMN) block using ropivacaine 0.2% into clinical protocol in February 2023.Main Outcome MeasuresPeri-procedure complications and post-operative opioid administration.ResultsThe clinical anatomy of the SZMN block is described in a stepwise and pictorial approach from superficial to deep structures. 43 patients underwent surgical interventions involving the palate (either intravelar veloplasty, Furlow palatoplasty or bilateral myomucosal buccinator flaps for palatal lengthening). 22 patients had a general anaesthetic and local anaesthetic infiltration and 21 had an additional SZMN block. There were no local or systemic complications associated with the SZMN block. There was no difference in the total dosing of post-operative ( P = .79) opioids between the groups.ConclusionsWe demonstrate the feasibility and safety of this procedure without the use of ultrasound guidance in a heterogenous group of paediatric patients undergoing palatal surgery. Regional anaesthesia should be considered as part of the multi-modal analgesic strategy, although it may be difficult to demonstrate a change in opioid use in clinical settings where enhanced recovery techniques are established, and opioid use is already low.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"11 1","pages":"10556656241284514"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Assessment of Adverse Events in Patients with 22q11.2 Deletion Syndrome Undergoing Palatoplasty: An Analysis of the NSQIP Pediatric Database. 对接受腭成形术的 22q11.2 缺失综合征患者不良事件的评估：NSQIP儿科数据库分析。

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-11 DOI: 10.1177/10556656241271748

Hannah J Bergman,Lindsey Asti,Richard E Kirschner

{"title":"An Assessment of Adverse Events in Patients with 22q11.2 Deletion Syndrome Undergoing Palatoplasty: An Analysis of the NSQIP Pediatric Database.","authors":"Hannah J Bergman,Lindsey Asti,Richard E Kirschner","doi":"10.1177/10556656241271748","DOIUrl":"https://doi.org/10.1177/10556656241271748","url":null,"abstract":"BACKGROUNDThe National Surgical Quality Improvement Program (NSQIP) Pediatric database has been used to identify factors related to adverse surgical outcomes in pediatric and craniofacial surgical procedures. Focusing on a historically \"higher-risk\" population, our aim was to assess the impact of demographics, comorbidities, and 22q11.2 deletion syndrome (22QDS) diagnosis on 30-day postoperative complications in patients undergoing primary palatoplasty.METHODSWe used the 2012-2020 NSQIP Pediatric database to identify patients ≤3 years with and without 22q11.2 deletion syndrome who underwent primary palatoplasty. Demographics, comorbidities, and perioperative characteristics were compared between those with and without 22QDS. Logistic regression was used to determine if children with 22QDS were more likely to experience a 30-day postoperative complication or readmission.RESULTSThere were 10,745 patients ≤3 years old who underwent primary palatoplasty; 83 (0.8%) of whom had 22QDS and 10,662 (99.8%) did not. Children with 22QDS were older when they underwent primary palatoplasty and more likely to have comorbidities. A total of 513 patients (4.8%) experienced a postoperative complication within 30 days and 255 were readmitted (2.4%). Of the 513, 8 (9.6%) had a 22QDS diagnosis and 505 (4.7%) did not. A diagnosis of 22QDS was not a significant independent risk factor for a complication (adjusted odds ratio (aOR) = 1.13; 95% confidence interval (CI): 0.50-2.54) or readmission (aOR = 1.74; 95% CI: 0.74-4.13) within 30 days.CONCLUSIONThis study found that the diagnosis of 22QDS was not an independent predictor of post-palatoplasty complication risk, and in fact 30-day complications are rare for those patients undergoing cleft palate repair, even among those patients with 22QDS.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"11 1","pages":"10556656241271748"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient Reported Outcomes in Patients with Cleft Lip and/or Palate Help Identify Youth at Risk for Suicidality 唇裂和/或腭裂患者的患者报告结果有助于识别有自杀风险的青少年

The Cleft Palate-Craniofacial Journal Pub Date : 2024-09-10 DOI: 10.1177/10556656241277694

Dominic J. Romeo, Theodor Lenz, Patrick Akarapimand, Jinggang J. Ng, Meagan Wu, Joseph A. Napoli, Jordan W. Swanson, Oksana Jackson, Jesse A Taylor, Leanne Magee

{"title":"Patient Reported Outcomes in Patients with Cleft Lip and/or Palate Help Identify Youth at Risk for Suicidality","authors":"Dominic J. Romeo, Theodor Lenz, Patrick Akarapimand, Jinggang J. Ng, Meagan Wu, Joseph A. Napoli, Jordan W. Swanson, Oksana Jackson, Jesse A Taylor, Leanne Magee","doi":"10.1177/10556656241277694","DOIUrl":"https://doi.org/10.1177/10556656241277694","url":null,"abstract":"ObjectiveTo identify associations between scores on the CLEFT-Q and Columbia-Suicide Severity Rating Scale (C-SSRS) Lifetime Version in patients with cleft lip and/or palate (CLP).DesignProspective.SettingTertiary care center.Patients, ParticipantsPatients ages six and older administered both the CLEFT-Q questionnaire and C-SSRS survey between 2019 and 2024.InterventionsMultidisciplinary care coordination facilitated by the team psychologist.Main Outcome Measure(s)Associations among demographics, CLEFT-Q responses, and suicidality.ResultsA total of 305 patients were included, 141 females (46.2%) and 164 males (53.8%). Fifty-one (16.7%) endorsed lifetime incidence of suicidal ideation, four (1.3%) endorsed suicidal behavior, 12 (3.9%) endorsed non-suicidal self-injury (NSSI), and one (0.3%) endorsed self-injurious behavior, intent unknown. Patients endorsing suicidal ideation had lower PROs in 12/13 categories on the CLEFT-Q questionnaire (p < 0.001). Those with suicidal behavior had lower PROs in three health-related quality of life categories (psychological function, p = 0.018; social function, p = 0.005; school function, p = 0.007), but no difference in other domains. A cutoff of ≤70 in the CLEFT-Q psychological function domain identified suicidal ideation with 72.9% sensitivity and 65.9% specificity and suicidal behavior with 100.0% sensitivity and 62.2% specificity.ConclusionsPatients with cleft lip and/or palate have increased risks for psychosocial challenges that are often missed by healthcare providers. This study reveals that patient-reported outcomes are worse in those with CLP who endorsed suicidal ideation and behavior. Low PRO responses identify suicidality with moderate sensitivity and specificity. Patients with low scores should be offered safety screenings and psychosocial support, ideally by mental healthcare professionals.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"3 1","pages":"10556656241277694"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incomes to Outcomes: A Global Assessment of Disparities in Cleft and Craniofacial Treatment 从收入到结果：裂隙和颅面治疗差异的全球评估

The Cleft Palate-Craniofacial Journal Pub Date : 2024-05-03 DOI: 10.1177/10556656241249821

Connor S. Wagner, Michaela K. Hitchner, Natalie M. Plana, Carrie Z. Morales, Lauren K. Salinero, Carlos E. Barrero, Matthew E. Pontell, Scott P. Bartlett, Jesse A. Taylor, Jordan W. Swanson

{"title":"Incomes to Outcomes: A Global Assessment of Disparities in Cleft and Craniofacial Treatment","authors":"Connor S. Wagner, Michaela K. Hitchner, Natalie M. Plana, Carrie Z. Morales, Lauren K. Salinero, Carlos E. Barrero, Matthew E. Pontell, Scott P. Bartlett, Jesse A. Taylor, Jordan W. Swanson","doi":"10.1177/10556656241249821","DOIUrl":"https://doi.org/10.1177/10556656241249821","url":null,"abstract":"ObjectiveRecent investigations focused on health equity have enumerated widespread disparities in cleft and craniofacial care. This review introduces a structured framework to aggregate findings and direct future research.DesignSystematic review was performed to identify studies assessing health disparities based on race/ethnicity, payor type, income, geography, and education in cleft and craniofacial surgery in high-income countries (HICs) and low/middle-income countries (LMICs). Case reports and systematic reviews were excluded. Meta-analysis was conducted using fixed-effect models for disparities described in three or more studies.SettingN/APatientsPatients with cleft lip/palate, craniosynostosis, craniofacial syndromes, and craniofacial trauma.InterventionsN/AResultsOne hundred forty-seven articles were included (80% cleft, 20% craniofacial; 48% HIC-based). Studies in HICs predominantly described disparities (77%,) and in LMICs focused on reducing disparities (42%). Level II-IV evidence replicated delays in cleft repair, alveolar bone grafting, and cranial vault remodeling for non-White and publicly insured patients in HICs (Grades A-B). Grade B-D evidence from LMICs suggested efficacy of community-based speech therapy and remote patient navigation programs. Meta-analysis demonstrated that Black patients underwent craniosynostosis surgery 2.8 months later than White patients ( P < .001) and were less likely to undergo minimally-invasive surgery (OR 0.36, P = .002).ConclusionsDelays in cleft and craniofacial surgical treatment are consistently identified with high-level evidence among non-White and publicly-insured families in HICs. Multiple tactics to facilitate patient access and adapt multi-disciplinary case in austere settings are reported from LMICs. Future efforts including those sharing tactics among HICs and LMICs hold promise to help mitigate barriers to care.","PeriodicalId":519225,"journal":{"name":"The Cleft Palate-Craniofacial Journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140841316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0