Cleft Palate-Craniofacial Journal最新文献

{"title":"Treacher Collins Syndrome Associated with Disproportionate Nervous System, Cardiovascular, Otologic Complications Among 1,114 Patients.","authors":"Jacqueline Kloos, David C Kaelber","doi":"10.1177/10556656231187302","DOIUrl":"10.1177/10556656231187302","url":null,"abstract":"<p><strong>Objective: </strong>To compare the rates of selected nervous system, cardiovascular, and otologic abnormalities in patients with and without Treacher Collins Syndrome (TCS).</p><p><strong>Design: </strong>Retrospective TriNetX platform cohort study.</p><p><strong>Setting: </strong>Aggregated and deidentified electronic health record (EHR) data from across the United States.</p><p><strong>Patients, participants: </strong>Patients with TCS (n = 1,114) and a propensity matched control cohort without TCS (n = 1,114 matched from n = 110,368,585).</p><p><strong>Main outcome measured: </strong>Prevalence and relative risk (RR) of selected diagnoses in a propensity-matched cohort.</p><p><strong>Results: </strong>The RR of congenital malformations of the circulatory system in patients with TCS was 8.5 (95% CI 4.44-16.28). Patients with TCS also had higher rates of otologic abnormalities including conductive hearing loss (RR 44, 95% CI 24-83) and nervous system disorders including movement disorders (RR 2.60, 95% CI 1.27-5.50) and recurrent seizures (RR 4.2, 95% CI 2.12-8.33).</p><p><strong>Conclusions: </strong>We found a significantly elevated risk in TCS patients within all three systems. We postulate that the nervous system effects may be the result of one of the TCS-linked genes, for which a mutation has also been associated with progressive ataxia, cerebellar atrophy, hypomyelination, and seizures. As the previously-identified causal genes influence neural crest cells that form the head and face, these cells may also populate cardiac structures, resulting in cardiovascular abnormalities. Finally, the characteristic craniofacial abnormalities identified in TCS impair hearing and are associated with increased risk of otitis media. Our findings may help researchers to hypothesize the function of the genes underlying TCS, as well as to inform the care of affected individuals.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10117552","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":"Analyzing Linguistic Disparities in Telehealth Care Outcomes at a Multidisciplinary Craniofacial Center.","authors":"Elizabeth Danial, Jennifer Rios, Ryan Badiee, Glenn Rosenbluth, Jason H Pomerantz","doi":"10.1177/10556656231187291","DOIUrl":"10.1177/10556656231187291","url":null,"abstract":"<p><strong>Objective: </strong>To examine linguistic disparities between English- and Spanish-speaking patients in access to care, satisfaction, and telehealth appointment attendance.</p><p><strong>Design: </strong>Retrospective study recording demographics for non-attendance analysis and conducting phone surveys assessing satisfaction with telehealth.</p><p><strong>Setting: </strong>Data was collected between March and December 2020 at the UCSF Craniofacial Center (CFC), a multidisciplinary pediatric clinic. Patients: English- and Spanish-speaking patients with a telehealth appointment. Interventions: The CFC offered language-concordant outreach, assistance with the telehealth platform, and interpreters at all telehealth appointments.</p><p><strong>Main outcome measures: </strong>Demographics and patient-reported satisfaction with telehealth, barriers, and instruction clarity.</p><p><strong>Results: </strong>Medicaid insurance was the only predictor of non-attendance. Surveys revealed that Spanish-speakers had 12.4 times the odds of lacking access to telehealth technology and 10.7 times the odds of needing help with logging on compared to English-speakers. There were no significant differences in satisfaction outcomes.</p><p><strong>Conclusions: </strong>We attribute this equity in satisfaction to our language-concordant outreach efforts.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ergonomics for Cleft Providers: A Brief Communication.","authors":"Usama S Hamdan, Wassim Najjar, Raj M Vyas, Lindsay Schuster, Sara Hussein, Robert A Younan, Mario Haddad, Beyhan Annan, Adam Johnson, Jordan W Swanson","doi":"10.1177/10556656231193971","DOIUrl":"10.1177/10556656231193971","url":null,"abstract":"<p><p>Musculoskeletal (MSK) injuries are the most common and debilitating work-related injuries among healthcare providers. These injuries often occur due to a lack of awareness and insufficient guidance during the early years of medical training. Recognizing the need to address this issue, the Comprehensive Cleft Care Workshop (CCCW) has taken steps to integrate an ergonomics session into its curriculum. The goal of this initiative is to enhance awareness on ergonomics, improve the integration of ergonomics into daily routine, and ultimately reduce the occurrence of MSK injuries among healthcare professionals.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319311","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":"Dr. ChatGPT: Utilizing Artificial Intelligence in Surgical Education.","authors":"Michael S Lebhar, Alexander Velazquez, Shelby Goza, Ian C Hoppe","doi":"10.1177/10556656231193966","DOIUrl":"10.1177/10556656231193966","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to explore the unexamined capabilities of ChatGPT in describing the surgical steps of a specialized operation, the Fisher cleft lip repair.</p><p><strong>Design: </strong>A chat log within ChatGPT was created to generate the procedural steps of a cleft lip repair utilizing the Fisher technique. A board certified craniomaxillofacial (CMF) surgeon then wrote the Fisher repair in his own words blinded to the ChatGPT response. Using both responses, a voluntary survey questionnaire was distributed to residents of plastic and reconstructive surgery (PRS), general surgery (GS), internal medicine (IM), and medical students at our institution in a blinded study.</p><p><strong>Setting: </strong>Authors collected information from residents (PRS, GS, IM) and medical students at one institution.</p><p><strong>Main outcome measures: </strong>Primary outcome measures included understanding, preference, and author identification of the procedural prompts.</p><p><strong>Results: </strong>Results show PRS residents were able to detect more inaccuracies of the ChatGPT response as well as prefer the CMF surgeon's prompt in performing the surgery. Residents with less expertise in the procedure not only failed to detect who wrote what procedure, but preferred the ChatGPT response in explaining the concept and chose it to perform the surgery.</p><p><strong>Conclusions: </strong>In applications to surgical education, ChatGPT was found to be effective in generating easy to understand procedural steps that can be followed by medical personnel of all specialties. However, it does not have expert capabilities to provide the minute detail of measurements and specific anatomy required to perform medical procedures.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937919","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 Comparison of Postoperative Outcomes between Unilateral and Bilateral Palatoplasty: Analysis of 2015-2020 Pediatric NSQIP Data.","authors":"Jessica L Marquez, Ashraf A Patel, Kaylee B Scott, Jack D Sudduth, Devin Eddington, Erinn Kim, Dana Johns, Alvin C Kwok, Jayant P Agarwal","doi":"10.1177/10556656231190517","DOIUrl":"10.1177/10556656231190517","url":null,"abstract":"<p><strong>Objective: </strong>We sought to identify differences in 30-day medical and surgical complications in unilateral versus bilateral palatoplasty.</p><p><strong>Design: </strong>The NSQIP-P 2015-2020 database was queried to identify cleft palate repairs using CPT codes. Cases were stratified as unilateral (Veau III) and bilateral (Veau IV) using ICD-9 and -10 codes.</p><p><strong>Setting: </strong>A nationally representative random sample.</p><p><strong>Patients/participants: </strong>A total of 3791 cases were identified with 2608 undergoing unilateral repair and 1183 undergoing bilateral repair.</p><p><strong>Main outcomes/measures: </strong>The postoperative outcomes of interest included surgical complications (surgical site infections, wound dehiscence), medical complications (pneumonia, urinary tract infection, seizure, cardiac arrest, bleeding/transfusions, systemic sepsis, unplanned intubation), readmission, and reoperation.</p><p><strong>Results: </strong>The bilateral cohort was older (696 days versus 619 days, <i>P</i> < .001) and had longer operative times (157.3 min versus 144.5 min, <i>P</i> < .001). The unilateral cohort had more comorbidities including developmental delay, structural CNS abnormalities, need for nutritional support, and bleeding disorders. The bilateral cohort had statistically significant higher occurrences of wound dehiscence (2.1% versus. 1.2%, <i>P</i> = .03) and readmission (3.2% versus 1.7%, <i>P</i> = .01). On multivariate analysis, bilateral cleft repair (OR: 1.83, CI: 1.176-2.840, <i>P</i> = .007) and ASA class 4 (OR: 13.1, CI 2.288- 62.586, <i>P</i> = .002) were associated with greater odds of readmission.</p><p><strong>Conclusion: </strong>Patients who underwent bilateral cleft repair had a higher proportion of 30-day postoperative complications and a two-fold increased odds of readmission. While palatoplasty is generally regarded as a safe procedure in the pediatric population, identifying factors related to an increased risk of early postoperative complications can help surgical teams better manage high-risk individuals.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10259908","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 Prenatal Diagnostic Imaging for Micrognathia: A Systematic Review and Meta-Analysis.","authors":"Caroline M Fields, Nicolas S Poupore, April N Taniguchi, Hussein Smaily, Shaun A Nguyen, Ryan D Cuff, Phayvanh P Pecha, William W Carroll","doi":"10.1177/10556656231190525","DOIUrl":"10.1177/10556656231190525","url":null,"abstract":"<p><strong>Objective: </strong>Studies evaluating the ability to diagnose and accurately predict the severity of micrognathia prenatally have yielded inconsistent results. This review aimed to evaluate reliability of prenatal diagnostic imaging in the diagnosis and characterization of micrognathia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Setting: </strong>Studies with a prenatal diagnosis of micrognathia via ultrasound with a confirmatory postnatal examination were included. Prenatal severity was defined with and without mandibular measurements. Extent of airway obstruction at birth was defined by level of intervention required. Meta-analyses of proportions and relative risk were performed.</p><p><strong>Patients: </strong>A total of 16 studies with 2753 neonates were included.</p><p><strong>Main outcome measures: </strong>Primary outcome was the efficacy of characterizing the degree of micrognathia on prenatal imaging as it relates to respiratory obstruction at birth. Secondary outcome was the accuracy of prenatal diagnosis with the utilization of mandibular measurements versus without.</p><p><strong>Results: </strong>Performing meta-analysis of proportions, the proportion of missed prenatal diagnoses of micrognathia made without mandibular measurements was 11.62% (95%CI 2.58-25.94). Utilizing mandibular measurements, the proportion of cases missed were statistically lower (0.20% [95%CI 0.00-0.70]). Patients determined to have severe micrognathia by prenatal imaging did not have a statistically significant increase in risk for more severe respiratory obstruction at birth (RR 3.13 [95%CI 0.59-16.55], <i>P</i> = .180).</p><p><strong>Conclusion: </strong>The proportion micrognathia cases missed when prenatal diagnosis was made without mandibular measurements was over 1 in 10, with mandibular measures improving accuracy. This study highlights the need for a uniform objective criterion to improve prenatal diagnosis and planning for postnatal care.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9911315","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":"Can Velopharyngeal MRI be Used in Individuals with Orthodontic Devices?","authors":"Jamie L Perry, Eshan Schleif, Xiang Ming Fang, Patrick M Briley, V Wallace McCarlie","doi":"10.1177/10556656231194511","DOIUrl":"10.1177/10556656231194511","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the influence of common pediatric orthodontic appliances on velopharyngeal (VP) MRI and to compare MR image sequences to determine if sequence parameters impact the visibility of key VP structures commonly assessed in clinical VP MRI.</p><p><strong>Design: </strong>Participants undergoing orthodontic treatment completed a VP MRI study. Level of distortion caused by orthodontic devices on 8 anatomical sites of interest and using variable MRI sequences was evaluated.</p><p><strong>Setting: </strong>Single institution.</p><p><strong>Participants: </strong>Nineteen participants undergoing orthodontic treatment.</p><p><strong>Main outcome: </strong>Level of distortion caused by metal artifacts and MR sequence used.</p><p><strong>Results: </strong>The results of this study demonstrate that appliances such as hyrax palatal expanders and braces with stainless steel brackets are acceptable for a VP MRI, while class II corrector springs are not recommended. The HASTE MRI sequence with 2D imaging techniques should be utilized if the child has orthodontic devices, while FSE and 3D imaging techniques are not recommended. The presence of wire spring coils and molar bands are likely to not to interfere with the MRI evaluation.</p><p><strong>Conclusions: </strong>Findings from this study suggest that the presence of orthodontic appliances does not hinder visualization of all velopharyngeal structures during an MRI. Therefore, careful consideration must be made prior to disqualifying or recommending patients for VP MRI.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011616","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":"Protocol Registration.","authors":"Vaibhav Sahni","doi":"10.1177/10556656231193544","DOIUrl":"10.1177/10556656231193544","url":null,"abstract":"<p><p>Prospective registration of systematic reviews is encouraged and forms part of the PRISMA guidelines. Providing information pertaining to protocol registration would potentially aid in improving the robustness of the report.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927287","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 RR- New app to Calculate Recurrence Risk in Cleft lip and Palate.","authors":"Rosa Helena Wanderley Lacerda, Alice Castro G Mendonça, Rebeca Andrade Laurentino, Paulo Germano Cavalcanti Furtado, Vitor Marques Filgueiras, Fernanda Maria Bezerra Filgueiras, Luan Carlos da Silva Bezerra, Alexandre Rezende Vieira","doi":"10.1177/10556656231191346","DOIUrl":"10.1177/10556656231191346","url":null,"abstract":"<p><strong>Objective: </strong>To describe the Cleft Recurrence Risk (Cleft RR) App, designed to be used on genetic counseling for cleft lip and/ or palate.</p><p><strong>Design: </strong>A validation study, single cohort.</p><p><strong>Setting: </strong>Tertiary care children's Hospital.</p><p><strong>Patients, participants: </strong>The manual obtained the results of 100 cases undergoing genetic counseling at the cleft lip and palate treatment center.</p><p><strong>Interventions: </strong>The application for genetic counseling for cleft lip and/ or palate is designed to calculate quickly the recurrence risk considering the ancestry, cleft type, sex, and family history and thus encourage the implementation of genetic counseling in cleft lip and palate centers around the world.</p><p><strong>Main outcome measure(s): </strong>The data were submitted to the Bland-Altman statistics.</p><p><strong>Results: </strong>After defining parameters the application development follows the steps: development, prototyping, and documentation. The validation of the calculated data was performed by comparing the results of 100 cases undergoing genetic counseling at the cleft lip and palate treatment center obtained by the manual method with the results obtained by the mobile app method; the data were submitted to the Bland-Altman statistics and a high concordance was found.</p><p><strong>Conclusions: </strong>The mobile app for use by healthcare professionals proved to be simple to use, easy to apply, and provided accurate results. Cleft Recurrence Risk is an application for smartphones developed for genetic counseling in cleft lip and palate, supplementary use by health professionals, and should not replace professional performance.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946777","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 Systematic Review: Early Simultaneous Vomer Flap with Primary Cleft Lip Repair, Does it Bring More Benefits?","authors":"Indri Lakhsmi Putri, Evan Savero Widiono, Stephanie Liana, Sandro Ruberto, Citrawati Dyah Kencono Wungu","doi":"10.1177/10556656231192295","DOIUrl":"10.1177/10556656231192295","url":null,"abstract":"<p><strong>Introduction: </strong>Vomer flap is a technique to close cleft lip and palate. This technique is a simple procedure that has many benefits. However, the vomer flap's application together with primary lip closure is still questionable.</p><p><strong>Objective: </strong>To find out whether the vomer flap's application in primary cleft lip repair can provide significant benefits.</p><p><strong>Design: </strong>A systematic review was conducted using the PRISMA methodology has been licensed in PROSPERO databases (CRD42023399487).</p><p><strong>Setting: </strong>A comprehensive search was set out, utilizing eight data sources up to March 2023.</p><p><strong>Participants: </strong>Both cohort studies and randomized control trials regarding the use of vomer flaps performed concurrently with cleft lip repair in children up to six months old.</p><p><strong>Results: </strong>This article involved 8 studies involving 542 patients who met the inclusion criteria, consisting of 6 retrospective cohort studies, 1 RCT study, and 1 prospective cohort study. Vomer flaps provide a reduction in palatal cleft distance of 3-5 mm, a relatively small number of fistulas (0-4%), improvement of velopharyngeal function (nasal tone and nasal emission), maximal development of the maxilla although it is still controversial.</p><p><strong>Conclusion: </strong>The vomer flap's application in primary cleft lip repair provides many advantages, such as reduced palatal and alveolar clefts, decreased risk of oronasal fistula, increased velopharyngeal function, and increased maxillary growth. It is reliable for the management of cleft lip and palate.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286895","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}