Katelyn J Kotlarek, Sierra Levene, Annalisa V Piccorelli, Gregory C Allen, Krystle Barhaghi, Ilana Neuberger
{"title":"Growth and Symmetry of the Levator Veli Palatini Muscle Within the First Two Years of Life.","authors":"Katelyn J Kotlarek, Sierra Levene, Annalisa V Piccorelli, Gregory C Allen, Krystle Barhaghi, Ilana Neuberger","doi":"10.1177/10556656231183776","DOIUrl":"10.1177/10556656231183776","url":null,"abstract":"<p><strong>Objective: </strong>To quantify differences in levator veli palatini (LVP) muscle dimensions based on age, sex, and race and determine the typical range of asymmetry between the left and right sides of the LVP under age 2.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Children's tertiary care hospital.</p><p><strong>Participants: </strong>A retrospective chart review of non-cleft patients under 2 who received a volumetric FLAIR MRI sequence within the past 18 months identified 216 patient scans. Exclusion criteria left 200 scans for analysis. Measurements of the LVP were obtained consistent with previous literature.</p><p><strong>Interventions: </strong>Corrected age, sex, and race.</p><p><strong>Main outcome measure(s): </strong>LVP muscle dimensions.</p><p><strong>Results: </strong>A significant (<i>P </i>< .0001) difference between corrected age groups based on the overall combination of LVP variables after controlling for sex and race. Significant age differences included average extravelar length (<i>P</i> < .0001), average intravelar length (<i>P</i> < .0001), midline thickness (<i>P</i> < .0001), and average (<i>P</i> < .0001) and difference (<i>P</i> = .0413) in insertion thickness. Significant sex differences included average intravelar length (<i>P</i> = .0412) and average insertion thickness (<i>P</i> = .0281). Significant race differences included average insertion thickness (<i>P</i> = .0334) and difference in intravelar length (<i>P</i> = .0473). Differences between left and right total length (<i>P</i> = .0491) and angle of origin (<i>P</i> < .0001) were significant.</p><p><strong>Conclusions: </strong>Differences in LVP morphology were observed in individuals under 2 years or age related to age, sex, and race. While asymmetry was significant in some dimensions, it varied by age range.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88554945","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}
Srishti Shailesh Ghorpade, Pritham N Shetty, Krishnamurthy Bonanthaya, Dipesh Rao
{"title":"Isolated Paramedian cleft of Lower LIP: A Rare Entity.","authors":"Srishti Shailesh Ghorpade, Pritham N Shetty, Krishnamurthy Bonanthaya, Dipesh Rao","doi":"10.1177/10556656231185971","DOIUrl":"10.1177/10556656231185971","url":null,"abstract":"<p><p><b>Objective:</b> To present a rare case of an isolated paramedian cleft of the lower lip. We describe the second case of isolated paramedian cleft of the lower lip. The pregnancy was realized in the fifth month prior to which the mother gives history of consumption of non-steroidal anti-inflammatory drugs (N.S.A.I.D.s) and a computed tomography (C.T.) scan. The cleft was repaired with a z-plasty for the mucosa and a z-plasty for the skin. We achieved good vermilion bulk, white roll continuity and functionality. We attributed this cleft to maternal exposure to NSAIDs and radiation during early pregnancy.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152907","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":"Effects of Secondary Alveolar Bone Grafting on Maxillary Growth in Cleft Lip or Palate Patients: A Systematic Review and Meta-Analysis.","authors":"Phavithrasri Kannan, Sanjeev Verma, Vinay Kumar, Raj Kumar Verma, Satinder Pal Singh","doi":"10.1177/10556656231188600","DOIUrl":"10.1177/10556656231188600","url":null,"abstract":"<p><p>To assess the effect of secondary alveolar bone grafting (SABG) on maxillary growth in patients with unilateral cleft lip or palate (UCL/P).</p><p><p>Systematic review and Meta-analysis.</p><p><p>Pubmed, Cochrane Library, Embase, Scopus, Web of Science and manual search was performed to assess the maxillary growth following SABG in UCL/P patients.</p><p><p>Non-syndromic patients with UCL/P.</p><p><p>Comparison of maxillary growth between patients with UCL/P who underwent SABG and UCL/P patients who had not undergone SABG or non-cleft control.</p><p><p>39 of the identified 233 articles were assessed for inclusion and exclusion criteria after duplicate removal and title and abstract reading. 7 articles (1 prospective, and 6 retrospective studies) were included in the qualitative analysis and 2 articles were subjected to quantitative analysis. Four studies had a low risk of bias and three studies had a moderate risk of bias. Meta-analysis revealed a significant reduction of SNA and no significant difference in ANB in the SABG group compared to the non-cleft control group(I<sup>2 </sup>= 0%). There was no significant difference in ANB between SABG and non-cleft control; however, results showed high heterogeneity(I<sup>2 </sup>= 83%). Meta-analysis of SNA and ANB showed no significant difference between SABG and the cleft control group; however, there was high heterogeneity.</p><p><p>The studies showed a low to moderate risk of bias. SABG causes inhibition of maxillary growth in patients with cleft lip or palate when compared to patients with non-cleft control. Due to high heterogeneity, comparison to cleft control showed insufficient evidence.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132264","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}
Jessica L Williams, Kelly N Cordero, Thomas J Sitzman
{"title":"Assessing the Agreement of Hypernasality and Audible Nasal Emission Ratings Between Audio-Recordings and a Clinic Setting.","authors":"Jessica L Williams, Kelly N Cordero, Thomas J Sitzman","doi":"10.1177/10556656231185494","DOIUrl":"10.1177/10556656231185494","url":null,"abstract":"<p><p>Assess agreement of hypernasality and audible nasal emission (ANE) ratings between audio-recordings and a clinic setting.</p><p><p>Cross-sectional study using retrospective clinical recordings.</p><p><p>Audio-recording ratings by two trained speech language pathologists.</p><p><p>Percent agreement and intra- and inter-rater reliability of perceptual ratings.</p><p><p>Intra-rater reliability (AC2) of 167 audio-recorded speech samples for the primary and secondary raters, respectively, was 0.82 and 0.79 for hypernasality; for ANE, it was 0.57 and 0.75. Inter-rater reliability was 0.77 for hypernasality and 0.63 for ANE. When comparing ratings made from audio-recording versus the original clinical ratings, intra-rater reliability was 0.85 and 0.61 (primary and secondary rater, respectively) for hypernasality and 0.21 and 0.34 for ANE.</p><p><p>Ratings for hypernasality made from audio recordings were consistent with clinical evaluation, while ratings of ANE were not. ANE ratings made from audio recordings may not be a valid measure of velopharyngeal insufficiency speech characteristics.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683846","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":"Reliability and Validity of the CLEFT-Q in a Chinese Context.","authors":"Yuzhe Ding, Wenying Kuang, Xinyu Zhang, Wenjuan Zhang, Jingyi Xu, Jianan Yan, Yanyu Guo, Jie Zheng, Wenjun Yuan","doi":"10.1177/10556656231184966","DOIUrl":"10.1177/10556656231184966","url":null,"abstract":"<p><strong>Objective: </strong>To develop an appropriate Chinese version of the CLEFT-Q through translation and cultural adaptation and to evaluate its reliability and validity.</p><p><strong>Design: </strong>The English CLEFT-Q was translated into Chinese following the International Society for Pharmacoeconomics and Outcomes Research guidelines, including cognitive debriefing interviews, and its reliability and validity were assessed.</p><p><strong>Participants: </strong>Patients (N = 246) were mostly in active orthodontic treatment, had a mean age of 14.7 ± 4.4 years, 29% were female, and were born with isolated cleft lip ± alveolus (12%), cleft palate (1%), or cleft lip and palate (87%).</p><p><strong>Main outcome measures: </strong>The Chinese CLEFT-Q, including 13 subscales covering Appearance, Health-Related Quality of Life (HRQOL), and Facial Function. Criterion validity instruments included the Negative Physical Self, Satisfaction with Life Scale, and Scale of Positive and Negative Experience.</p><p><strong>Results: </strong>The wording of 67 items was adapted in the final translation. The internal consistency of the Chinese version of the CLEFT-Q was high based on Cronbach's alphas of 0.85 to 0.98 and split-half reliability of 0.85 to 0.92. Exploratory and confirmatory factor analyses yielded three factors, which demonstrated construct validity by broadly matching the structure of the original CLEFT-Q. The Appearance and HRQOL dimensions had weak to moderate correlations (r = -0.35 to 0.67) with the corresponding instruments for criterion validity.</p><p><strong>Conclusions: </strong>The Chinese version of the CLEFT-Q is a patient-reported outcome measure that can reflect the quality of life of Chinese patients with cleft lip and/or palate with good reliability and validity.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683844","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}
Jamie L Perry, Imani R Gilbert, Fangxu Xing, Riwei Jin, David P Kuehn, Ryan K Shosted, Jonghye Woo, Zhi-Pei Liang, Bradley P Sutton
{"title":"Preliminary Development of an MRI Atlas for Application to Cleft Care: Findings and Future Recommendations.","authors":"Jamie L Perry, Imani R Gilbert, Fangxu Xing, Riwei Jin, David P Kuehn, Ryan K Shosted, Jonghye Woo, Zhi-Pei Liang, Bradley P Sutton","doi":"10.1177/10556656231183385","DOIUrl":"10.1177/10556656231183385","url":null,"abstract":"<p><strong>Objective: </strong>To introduce a highly innovative imaging method to study the complex velopharyngeal (VP) system and introduce the potential future clinical applications of a VP atlas in cleft care.</p><p><strong>Design: </strong>Four healthy adults participated in a 20-min dynamic magnetic resonance imaging scan that included a high-resolution T2-weighted turbo-spin-echo 3D structural scan and five custom dynamic speech imaging scans. Subjects repeated a variety of phrases when in the scanner as real-time audio was captured.</p><p><strong>Setting: </strong>Multisite institution and clinical setting.</p><p><strong>Participants: </strong>Four adult subjects with normal anatomy were recruited for this study.</p><p><strong>Main outcome: </strong>Establishment of 4-D atlas constructed from dynamic VP MRI data.</p><p><strong>Results: </strong>Three-dimensional dynamic magnetic resonance imaging was successfully used to obtain high quality dynamic speech scans in an adult population. Scans were able to be re-sliced in various imaging planes. Subject-specific MR data were then reconstructed and time-aligned to create a velopharyngeal atlas representing the averaged physiological movements across the four subjects.</p><p><strong>Conclusions: </strong>The current preliminary study examined the feasibility of developing a VP atlas for potential clinical applications in cleft care. Our results indicate excellent potential for the development and use of a VP atlas for assessing VP physiology during speech.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037037","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}
Gabriel M Hayek, Hwi Sean Moon, Violeta Radenovich, David F Jimenez, David M Yates
{"title":"A Rare Case of Sagittal Sinus Obstruction Following Posterior Cranial Vault Distraction Osteogenesis.","authors":"Gabriel M Hayek, Hwi Sean Moon, Violeta Radenovich, David F Jimenez, David M Yates","doi":"10.1177/10556656231185707","DOIUrl":"10.1177/10556656231185707","url":null,"abstract":"<p><p>Posterior cranial vault distraction osteogenesis (PCVDO) is a relatively new paradigm in the treatment of syndromic craniosynostosis, having first been introduced in 2009. PCVDO directly addresses the underdeveloped cranial vault and appears to allow for a larger increase in intracranial volume when compared to traditional techniques. Although reported as safe in the literature, critical appraisal is still required as PCVDO is a relatively uncommon procedure that may require greater numbers to detect true complication rates. The overall reported incidence of serious complications in PCVDO to date is low. This presentation highlights a rare case of sagittal sinus obstruction following posterior cranial vault distraction and raises questions as to the safest technical considerations when planning the operation.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9689081","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}
Ricardo Correa da Costa Dias, Maria Noel Marzano Rodrigues, Ivy Kiemle Trindade-Suedam, Sergio Henrique Kiemle Trindade
{"title":"Tomographic Evaluation of the Upper Cervical Spine in Patients with Cleft lip and Palate and Class III Malocclusion.","authors":"Ricardo Correa da Costa Dias, Maria Noel Marzano Rodrigues, Ivy Kiemle Trindade-Suedam, Sergio Henrique Kiemle Trindade","doi":"10.1177/10556656231186968","DOIUrl":"10.1177/10556656231186968","url":null,"abstract":"<p><strong>Objective: </strong>To perform a morphometric analysis of the upper cervical spine (UCS) by means of cone-beam computed tomography (CBCT) for the diagnosis of malformations or craniocervical instabilities in patients with cleft lip and palate (CLP) and class III malocclusion.</p><p><strong>Materials and methods: </strong>A total of 72 CBCTs from adult patients (48 male and 24 female) with Angle Class III malocclusion were divided into three groups: 1) Unilateral cleft lip and palate (UCLP) (n = 29; male = 65.5%; age = 24, 2 ± 4.2 years); 2) Bilateral cleft lip and palate (BCLP) (n = 18; male = 83.3%; age = 26.4 ± 6.0 years); 3) Control group (CON) (n = 25; male = 56.0%; age = 27.8 ± 9.3 years). The version 11.7 of the Dolphin® software (Chatsworth, California, USA) was used to evaluate the morphometric measurements and anomalies of the UCS. Data were analyzed by descriptive and inferential statistics (p ≤ 0.05).</p><p><strong>Results: </strong>For the UCLP, BCLP and CON groups, respectively, the measures were: atlantodental interval (2.1 ± 0.5; 2.1 ± 0.4; 2.0 ± 0.3 mm), basion-opisthion (35.9 ± 3.2; 36.4 ± 3.0; 34.7 ± 1.9 mm), hyoid-C3 (34.5 ± 3.7; 34.5 ± 5.2; 35.3 ± 4.5 mm), and hyoid-sella (108.1 ± 9.8; 111.3 ± 9.2; 109.7 ± 10 mm); clivus-canal angle (152.3 ± 13; 150.3 ± 10; 150.7 ± 10°) and Torg-Pavlov index (1.0 ± 0.2; 1.0 ± 0.1; 1.1 ± 0.2). Potentially unstable anomalies and malformations were more prevalent in the UCLP group (34,4%).</p><p><strong>Conclusion: </strong>Subjects with UCLP presented compressive or unstable anomalies on upper cervical spine, more frequently than controls and BCLP, despite the lack of statistically significant differences among groups. Future studies could increase the safety of patients and healthcare professionals specialized in craniofacial anomalies.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9780919","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}
Daniel R Awad, Noel Jabbour, Matthew Ford, Jennifer L McCoy, Jesse A Goldstein, Joseph E Losee, Amber D Shaffer
{"title":"Social Determinants of Health in Early Otologic and Audiologic Evaluation in an Interdisciplinary Cleft-Craniofacial Clinic.","authors":"Daniel R Awad, Noel Jabbour, Matthew Ford, Jennifer L McCoy, Jesse A Goldstein, Joseph E Losee, Amber D Shaffer","doi":"10.1177/10556656231186275","DOIUrl":"10.1177/10556656231186275","url":null,"abstract":"<p><strong>Objective: </strong>Investigate associations between socioeconomic indicators of healthcare access with family compliance with cleft-related otologic and audiologic care within an interdisciplinary model.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Subjects and setting: </strong>Children born 2005-2015 who presented to the Cleft-Craniofacial Clinic (CCC) at a quaternary care children's hospital.</p><p><strong>Interventions: </strong>Associations between main outcome measures and Area Deprivation Index (ADI), median household income for zip code, distance from hospital, and insurance status were evaluated.</p><p><strong>Main outcome measures: </strong>Cleft types, ages at presentation to outpatient clinic (cleft, otolaryngology, and audiology), and ages at procedures (first tympanostomy tube insertion (TTI), lip repair, and palatoplasty) were measured.</p><p><strong>Results: </strong>Most patients were male (147/230, 64%) with cleft lip and palate (157/230, 68%). Median age at first cleft, otolaryngology, and audiology visits were 7 days, 86 days, and 5.9 months, respectively. Private insurance predicted lower no-show rates (p = .04). Age at first CCC visit was younger for patients with private insurance (p = .04) and older for those who lived further from the hospital (p = .002). Age at lip repair was positively correlated with national ADI (p = .03). However, no socioeconomic status (SES) proxy or proximity to hospital was associated with delays in first otolaryngology or audiology examination or TTI.</p><p><strong>Conclusion: </strong>Once children become established within an interdisciplinary CCC, SES appears to bear little influence on cleft-related otologic and audiologic care. Future efforts should aim to elucidate which aspects of the interdisciplinary model maximize multisystem cleft care coordination and increase access for higher risk populations.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9751332","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}
C Tonello, G B Dias, R B Nunes, C Y Fussuma, L R Sousa, L B Feitosa, R L Flores, N Alonso
{"title":"Mandibular Dysmorphology and Clinical Presentation in Treacher Collins Syndrome.","authors":"C Tonello, G B Dias, R B Nunes, C Y Fussuma, L R Sousa, L B Feitosa, R L Flores, N Alonso","doi":"10.1177/10556656231184967","DOIUrl":"10.1177/10556656231184967","url":null,"abstract":"<p><strong>Introduction: </strong>Treacher Collins syndrome is a rare congenital disease characterized by the multiple craniofacial malformations. Although the deformities affecting patients with Treacher Collins syndrome have been well characterized, the effects of these malformations to clinical severity of the syndrome are not well understood.</p><p><strong>Objective: </strong>To determine the association of specific Treacher Collins mandibular malformations with clinical severity.</p><p><strong>Design: </strong>A retrospective radiographic observational study<b>.</b></p><p><strong>Setting: </strong>Study conducted at a single institution, a quaternary craniofacial care center.</p><p><strong>Patients: </strong>54 patients with Treacher Collins syndrome.</p><p><strong>Interventions: </strong>Computed tomography (CT), clinical photographs and medical history were included in this analysis. Mandibles were isolated from CT data and reconstructed in three dimensions using Mimics software. Cephalometric measurements were performed on CT data. Clinical severity was determined by Teber and Vincent scores. Association of craniofacial dysmorphology to clinical severity was determined by Spearman rank coefficient.</p><p><strong>Main outcome measures: </strong>The main results obtained were the measurements of the mandibles and the quantification of the malformations of the evaluated patients.</p><p><strong>Results: </strong>Among the most frequent findings in the sample are hypoplasia of the zygomatic complex, descending palpebral cleft and mandibular hypoplasia. Patients with a lower ramus/corpus ratio had a higher (more severe) Teber and Vincent classification.</p><p><strong>Conclusion: </strong>Patients with the most compromised mandible are also the patients with the highest number of malformations, thus, the most severe patients.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150187","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}