Cleft Palate Craniofac. J. [JOURNAL]
Sun
200 papers
Intelligibility in 3- and 5-Year-Old Children with Cleft Lip and/or Palate: Reference Data for Intelligibility in Context Scale Scores.
Davies A, McLeod S, Wren Y
Cleft Palate Craniofac J · 2026 Jun · PMID 42261682 · Publisher ↗
Objectivea) Provide reference data for the Intelligibility in Context Scale (ICS) for children born with cleft lip and/or palate and (b) compare ICS scores: between cleft types; with typically developing and normative sa...
Objectivea) Provide reference data for the Intelligibility in Context Scale (ICS) for children born with cleft lip and/or palate and (b) compare ICS scores: between cleft types; with typically developing and normative samples; and across ages 3- and 5-year-old children.DesignLongitudinal prospective cohort study.SettingQuestionnaire data from the Cleft Collective.ParticipantsThree-year-old (928) and 5-year-old children (795) born with cleft lip and/or palate.Main Outcome Measure(s)ICS - parent-reported measure using a 5-point Likert scale to indicate how intelligible their child is with seven different communication partners.ResultsMedian scores for children born with cleft lip only were higher (4.14, 95% CI = 4.00-4.14 for 3-year-olds; 5.00, 95% CI = 4.29-5.00 for 5-year-olds) than those born with any form of cleft palate (3.71, 95% CI = 3.57-3.86 for 3-year-olds; 4.14, 95% CI = 4.14-4.29 for 5-year-olds). Scores for children born with cleft lip only aligned with studies comprising typically developing children and normative samples, whereas those born with any form of cleft palate did not. Children born with cleft palate and a diagnosed syndrome scored lower than those born with non-syndromic cleft palate. For children who had data at both ages, 75.4% showed improvement over time, 14.3% stayed the same and 10.3% scored lower at age 5.ConclusionReference data are now available for children with the major cleft subtypes which can be used for comparison in clinical settings. These data show how children born with cleft compare with the non-cleft population and change over time.
Positive Longitudinal Caregiver Behavioral Ratings and Self-Reported Quality of Life in Youth With Cleft Lip and Palate in Treatment for Class III Malocclusion.
Johns AL, Zukin J, Yen L … +4 more , Dass A, Sheller B, Kapadia HP, Yen SL
Cleft Palate Craniofac J · 2026 Jun · PMID 42253035 · Publisher ↗
ObjectiveThis study describes behavior and quality of life (QoL) in youth with cleft lip and palate (CLP) during treatment for class III malocclusion.DesignProspective cohorts followed at baseline, maximal correction, tr...
ObjectiveThis study describes behavior and quality of life (QoL) in youth with cleft lip and palate (CLP) during treatment for class III malocclusion.DesignProspective cohorts followed at baseline, maximal correction, treatment completion with debanding, and 1-year follow-up.ParticipantsYouth with CLP (n = 64-114) undergoing protraction (58%) or orthognathic surgery (42%) and their caregivers (n = 47-97).Main Outcome Measure(s)Child/Adult Behavior Checklists (C/ABCL) and Youth Quality of Life-Facial Differences (YQOL-FD).ResultsC/ABCL Externalizing, Internalizing, and Total Problems and YQOL-FD Negative Consequences, Negative Self-Image, and Stigma were significantly lower than norms across time points (Cohen's d = -0.22 to -0.93). Highest proportions above clinical cutoffs were for Internalizing (10%-17%) and Negative Self-Image (13%-15%). There were a few changes over time, and no differences based on treatment outcome.ConclusionsYouth with CLP had overall positive adjustment during treatment for class III malocclusion. Supports may target internalizing and self-image concerns.
Evaluation of Osteomeatal Complex Anatomical Variations, Pathologies and Nasal Cavity Volume in Patients with Cleft Lip and Palate.
Cebeci T, Polat Akmansoy B
Cleft Palate Craniofac J · 2026 Jun · PMID 42253028 · Publisher ↗
ObjectiveTo compare osteomeatal complex (OMC) anatomical variations and nasal cavity airway volume between individuals with cleft lip and palate (CLP) and healthy controls using cone beam computed tomography (CBCT).Desig...
ObjectiveTo compare osteomeatal complex (OMC) anatomical variations and nasal cavity airway volume between individuals with cleft lip and palate (CLP) and healthy controls using cone beam computed tomography (CBCT).DesignRetrospective, cross-sectional study.SettingDepartment of dentomaxillofacial radiology.Patients/ParticipantsCBCT images of 200 individuals were evaluated: 100 patients with CLP (mean age 13.64 ± 4.32 years) and 100 age- and sex-matched controls (mean age 13.67 ± 4.32 years). Patients with syndromes, maxillofacial trauma, prior orthognathic surgery, or inadequate image quality were excluded.Main Outcome MeasuresPresence of OMC anatomical variations and nasal cavity airway volume.ResultsAgger nasi cells were the most common anatomical variation and hypertrophic turbinates were the most frequent pathology in both groups. Haller cells ( = 0.006) and nasal septal pneumatization ( = 0.001) were more prevalent in controls. In contrast, paradoxical middle turbinate ( = 0.015), nasal septal deviation ( = 0.001), and mucosal thickening ( = 0.001) were more frequent in CLP. Total nasal cavity airway volume did not differ significantly between groups.ConclusionsIndividuals with CLP exhibit distinct OMC anatomical patterns compared with controls; however, total nasal cavity volume is not significantly altered. These findings indicate that regional OMC alterations and overall nasal cavity volume represent related but distinct anatomical constructs.
Long-Term Clinical Results of Alveolar Bone Regeneration Using Octacalcium Phosphate Granules and Atelocollagen Complex Grafting in Alveolar Cleft.
Maeda-Iino A, Marutani K, Nakagawa S … +4 more , Kibe T, Saijo H, Nakamura N, Miyawaki S
Cleft Palate Craniofac J · 2026 Jun · PMID 42249746 · Publisher ↗
This case report aimed to clarify the long-term bone formation from the grafting of octacalcium phosphate granules and atelocollagen complex (OCP/Col) into the alveolar cleft until the completion of orthodontic treatment...
This case report aimed to clarify the long-term bone formation from the grafting of octacalcium phosphate granules and atelocollagen complex (OCP/Col) into the alveolar cleft until the completion of orthodontic treatment in 2 patients with unilateral CLA. Both patients underwent OCP/Col grafting at age 9 years and 3 months. Clear bone bridging was observed 6 months or 3 years after grafting, and bone formation was further promoted by the edgewise treatment. The results suggested that the osteogenic induction phase can last for several years in some cases, and it is important to understand this characteristic when formulating treatment plans.
Volumetric Analysis of the Maxillary Sinus in Patients with Cleft Lip and Palate Before and After Orthognathic Surgery.
Garcia PR, Gringo CPO, Ferreira GR … +3 more , Silveira ITTD, Souza IF, Yaedú RYF
Cleft Palate Craniofac J · 2026 Jun · PMID 42244200 · Publisher ↗
ObjectiveTo evaluate maxillary sinus volumetric changes in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) undergoing Le Fort I osteotomy.DesignRetrospective observational s...
ObjectiveTo evaluate maxillary sinus volumetric changes in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) undergoing Le Fort I osteotomy.DesignRetrospective observational study.SettingSingle tertiary craniofacial rehabilitation center.ParticipantsA total of 200 patients aged 18 years or older were included, comprising 100 individuals with UCLP and 100 with BCLP, all presenting preoperative and 1-year postoperative cone-beam computed tomography scans.InterventionsAll participants underwent Le Fort I osteotomy as part of orthognathic surgical treatment.Main Outcome MeasuresVolumetric segmentation of the maxillary sinuses and sinus lesions was performed using ITK-SNAP software. Volumes were measured in cubic millimeters using preoperative and 1-year postoperative cone-beam computed tomography scans.ResultsIn UCLP patients, no significant differences were observed in total maxillary sinus volume between preoperative and postoperative periods, although lesion volume was significantly reduced. In BCLP patients, a significant postoperative increase in sinus volume was observed, accompanied by a reduction in lesion volume. In both groups, the cleft side consistently presented smaller sinus volumes.ConclusionsMaxillary sinus volume remains smaller on the cleft side regardless of surgical intervention. Le Fort I osteotomy does not significantly affect sinus volume in UCLP patients, whereas BCLP patients demonstrate a postoperative volumetric increase.
Nationwide Spatial Analysis of Orofacial Cleft Prevalence in Ecuador: Geographic Variations and Clustering Across the Andean Region.
Posso AN, Neira M, Lee BT … +1 more , Vasconez HC
Cleft Palate Craniofac J · 2026 Jun · PMID 42244162 · Publisher ↗
ObjectiveTo determine the estimated birth prevalence of orofacial clefts in Ecuador, describe the demographic characteristics of these children, evaluate temporal trends, assess regional and provincial disparities, and p...
ObjectiveTo determine the estimated birth prevalence of orofacial clefts in Ecuador, describe the demographic characteristics of these children, evaluate temporal trends, assess regional and provincial disparities, and perform spatial analyses to identify geographic clusters.DesignCross-sectional study.SettingEcuador; national hospital discharge and live birth registries maintained by the National Institute of Statistics and Census, 2018-2024.Patients, participantsChildren diagnosed with cleft lip (CL), cleft palate (CP), or cleft lip and palate (CLP) between 2018 and 2024 (ICD-10 codes Q35-Q37).InterventionsNone; observational study.Main Outcome MeasureThe estimated birth prevalence of cleft lip and/or cleft palate (CL/P) was defined as the number of cases per 10,000 live births.ResultsA total of 3970 children were identified with CL/P between 2018 and 2024, corresponding to an estimated birth prevalence of 21.94 per 10,000 live births. The lowest estimated birth prevalence occurred in 2020, and only CP diagnosis demonstrated a significant temporal change, with a decline from 2018 to 2020 followed by an increase from 2020 to 2024. The Highlands region exhibited the highest estimated birth prevalence. Provincial estimated birth prevalence ranged from 11.04 to 43.56 per 10,000, with Carchi and Napo showing the highest burdens. Flexible and circular spatial scan statistics consistently identified high-risk clusters concentrated in the central and northern Highlands, confirming robust geographic clustering.ConclusionOrofacial clefts in Ecuador demonstrate one of the highest estimated births prevalences reported worldwide, with substantial regional and provincial variation. High-prevalence clusters were concentrated in the Highlands.
Computationally Guided Simulation-Based Surgical Correction of Nasal Airway Obstruction in Patients With Cleft Lip Nasal Deformity.
Lin E, Sicard RM, Martin HL … +5 more , Gosman RE, Shah R, Trotta R, Marcus JR, Frank-Ito DO
Cleft Palate Craniofac J · 2026 Jun · PMID 42237863 · Publisher ↗
To evaluate different virtual-surgical interventions for the correction of unilateral cleft lip nasal deformity (uCLND)-induced nasal airway obstruction (NAO) using computational fluid dynamics (CFD) modeling.Preliminary...
To evaluate different virtual-surgical interventions for the correction of unilateral cleft lip nasal deformity (uCLND)-induced nasal airway obstruction (NAO) using computational fluid dynamics (CFD) modeling.Preliminary pilot study involving virtual-surgical interventions based on pre-surgery computed tomography (CT) imaging with CFD analysis.Academic medical center.Five subjects aged ≥15 years with uCLND who underwent preoperative CT imaging.Virtual-surgical procedures involving varying combinations of inferior turbinate reduction (ITR), anterior (cartilaginous) septoplasty (AS), and posterior (osseous) septoplasty (PS).CFD-identified greatest obstructive site, changes in nasal resistance and airflow distribution calculated from airflow simulations in preoperative and virtual-surgery nasal models, correlation of resistance changes with the minimal clinically important difference (MCID) for patient-reported Nasal Obstruction Symptom Evaluation (NOSE) scores, and evaluation of efficacious virtual procedures balancing surgical complexity.Preoperatively, all subjects had greater resistance on the cleft side. Isolated septoplasty reduced bilateral resistance by <10%. Cleft-side ITR ± AS and/or PS reduced bilateral resistance by 32% to 54%. Bilateral ITR ± AS/PS achieved the largest improvements, with median reductions of 50% to 66% in bilateral resistance. Non-cleft ITR reduced resistance on the non-cleft side but often worsened airflow asymmetry. The number of procedures resulting in resistance improvements past the MCID threshold varied among subjects.CFD-based virtual-surgical procedures indicated that ITR alone or with septoplasty provided the most effective improvement in nasal resistance and airflow for uCLND. Patient-specific anatomy strongly influenced efficacy, supporting the rationale for the use of computational modeling to assist in personalized surgical planning.
Congenital Mid-line Cervical Cleft: A Case Report.
Peapally Venugopal A, Tirumalaraju AS, Peethala RS … +3 more , Thirunagari S, Telang N, Pawar SJ
Cleft Palate Craniofac J · 2026 Jun · PMID 42237859 · Publisher ↗
Congenital midline cervical cleft (CMCC) is a rare congenital malformation in the anterior region of the neck with an incidence of 1.7-2.0%. CMCC can be associated with other defects in the midline-like cleft of the lowe...
Congenital midline cervical cleft (CMCC) is a rare congenital malformation in the anterior region of the neck with an incidence of 1.7-2.0%. CMCC can be associated with other defects in the midline-like cleft of the lower lip, mandible, chin, tongue, and sternum. It may cause micrognathia and contracture of the cervical region. Early diagnosis and surgical excision before 2 years should be done. We present a male neonate who was diagnosed with CMCC at birth. Ultrasound and magnetic resonance imaging of the neck confirmed the diagnosis. The child underwent surgical excision of the lesion at 3 years of age and is doing well.
Progressive Overgrowth of Costochondral Graft in a Case of Hemifacial Microsomia: A Rare and Severe Case.
Zarasade L, Windura CA, Hutagalung MR … +1 more , Andana A
Cleft Palate Craniofac J · 2026 Jun · PMID 42237857 · Publisher ↗
Costochondral grafts (CCGs) are widely used for mandibular condyle reconstruction in children due to their growth potential, yet their unpredictable behavior remains a challenge. We present a rare case of progressive CCG...
Costochondral grafts (CCGs) are widely used for mandibular condyle reconstruction in children due to their growth potential, yet their unpredictable behavior remains a challenge. We present a rare case of progressive CCG overgrowth in a 17-year-old male with hemifacial microsomia, resulting in severe facial asymmetry despite prior corrective surgeries. Clinical assessment revealed a 2.5 cm ramus discrepancy and marked mandibular deviation. Management required staged surgical correction, including graft excision, osteotomies, and genioplasty. This case illustrates the potential for extreme CCG overgrowth beyond skeletal maturity and emphasizes the need for vigilant long-term surveillance and individualized treatment planning.
Publication Trends in Craniofacial Cleft Reconstruction: A PubMed-Based Bibliometric Analysis of the Literature from 2000 to 2025.
Apurva A
Cleft Palate Craniofac J · 2026 Jun · PMID 42237854 · Publisher ↗
ObjectiveTo analyze publication trends and descriptive patterns in PubMed-indexed literature on craniofacial cleft reconstruction from 2000 to 2025.DesignBibliometric analysis.SettingPubMed database.Patients/Participants...
ObjectiveTo analyze publication trends and descriptive patterns in PubMed-indexed literature on craniofacial cleft reconstruction from 2000 to 2025.DesignBibliometric analysis.SettingPubMed database.Patients/ParticipantsFifty-seven records were screened by title and abstract, and 41 articles met the eligibility criteria.InterventionsNone.Main Outcome Measure(s)Annual publication trend and distribution of journals, study types, reconstructive themes, and follow-up patterns.ResultsThe included literature was limited in volume and unevenly distributed across the study period. The earliest included article was published in 2003, and the highest annual output was observed in 2014 with 5 publications. Most studies were case reports, case series, or single-center retrospective experiences. was the most frequent publication venue, followed by and . Recurrent themes included Tessier cleft subtypes, orbital and eyelid reconstruction, nasal and alar reconstruction, midfacial correction, and staged long-term management.ConclusionsPubMed-indexed literature on craniofacial cleft reconstruction from 2000 to 2025 was limited and heterogeneous and was dominated by descriptive surgical reporting. The field remains driven largely by institution-specific experience, highlighting the need for standardized outcome reporting and longer structured follow-up.
Cone Beam Computed Tomography-Based Morphological Assessment of the Infraorbital Canal in Patients With Cleft Lip and Palate.
Çukurluoglu A, Dilek F, Sönmez ZF … +1 more , Öztürk T
Cleft Palate Craniofac J · 2026 Jun · PMID 42231853 · Publisher ↗
ObjectivesThis study aimed to anatomically evaluate the infraorbital canal (IOC) by comparing patients with cleft lip and palate (CLP) and controls.DesignRetrospective cross-sectional observational study.SettingDepartmen...
ObjectivesThis study aimed to anatomically evaluate the infraorbital canal (IOC) by comparing patients with cleft lip and palate (CLP) and controls.DesignRetrospective cross-sectional observational study.SettingDepartment of Oral and Maxillofacial Radiology, Faculty of Dentistry.ParticipantsSixty-four children and adolescents aged 13-18 years were included: 36 with unilateral CLP (UCLP), 12 with bilateral CLP (BCLP), and 16 controls.InterventionsNone; purely observational.Main Outcome Measure(s)Cone-beam computed tomography scans were analyzed bilaterally and grouped as cleft side of UCLP (UCLP-CS), non-cleft side of UCLP (UCLP-NCS), BCLP, and control. Parameters examined included initial and termination diameters of the IOC (D and D), IOC length (IOF-C), direct distance between the infraorbital foramen and groove (IOF-S), distances from the IOC to the midline and lateral nasal cavity wall (MW and LNW), anterior, posterior, and horizontal angles of the IOC, IOC protrusion type and the presence of septa and Haller cells in the maxillary sinus.ResultsThere was no significant difference for age and gender between the groups ( = .890 and = .879). In the UCLP-CS group, the D, IOF-C, MW, and LNW values were significantly lower compared to the control group ( = .034, = .035, = .007, = .003, and = .012). IOF-S values were significantly lower in the UCLP-NCS group compared to the control group ( = .041).ConclusionsCleft conditions can affect IOC position and morphology, especially on the cleft side of UCLP patients, and should be considered during surgery or anesthesia.
Exploring Experiences of Decision-Making for Appearance-Altering Lip/Nose Surgery in Adults Born With a Cleft Lip and/or Palate.
Ferguson J, De Boos D, Tickle A … +1 more , Shepherd L
Cleft Palate Craniofac J · 2026 Jun · PMID 42231844 · Publisher ↗
ObjectiveAdults born with a cleft lip and/or palate (CL/P) may experience appearance-related distress and seek surgery to alter the appearance of their lip and/or nose. Little is known about the psychological experience...
ObjectiveAdults born with a cleft lip and/or palate (CL/P) may experience appearance-related distress and seek surgery to alter the appearance of their lip and/or nose. Little is known about the psychological experience of this decision-making process, which is often their first opportunity to make surgical choices independently. This study aimed to explore the experiences of adults with CL/P making decisions about lip and/or nose surgery to alter their appearance.DesignA qualitative study was conducted.: A regional cleft service in the United Kingdom.: A total of 12 adults (9 women, 3 men), ranging from 20 to 61 years, had either decided to pursue surgery, were in the process of deciding to pursue surgery, or had lip and/or nose surgery in the previous 6 months to alter their appearance.: Semi-structured interviews were completed with all participants either via video (N = 10) or telephone (N = 2), along with a demographic questionnaire to provide contextual information for findings.ResultsThree themes were created during inductive-deductive thematic analysis: legacy of adversity (implicit and explicit shaping how participants viewed themselves), conflict driven by fear and emotional investment (related to uncertain outcomes, dual experiences, and identity erasure), and taking back control of decisions (pragmatically and by taking ownership, which was not without challenge).ConclusionsFor adults considering lip or nose surgery, psychological support may be helpful for patients to process previous aversive experiences and/or manage fear or uncertainty around decision-making.
Trends in Cleft Palate Incidence in the Era of Prenatal Ultrasonography and Early Detection.
Longfellow GA, Ndem IE, Shetty PN … +5 more , Kapsalis CN, Mehta NR, Pillai M, Wood J, Calder K
Cleft Palate Craniofac J · 2026 Jun · PMID 42231814 · Publisher ↗
ObjectiveTo evaluate whether temporal changes in prenatal detection and North Carolina abortion rates are associated with live-birth cleft palate (CP ± L) severity phenotypes.DesignRetrospective cohort study linking pati...
ObjectiveTo evaluate whether temporal changes in prenatal detection and North Carolina abortion rates are associated with live-birth cleft palate (CP ± L) severity phenotypes.DesignRetrospective cohort study linking patient-level clinical data to annual state abortion rates. Analyses included Pearson correlation, multivariable logistic, and interrupted time-series modeling.SettingSingle-center craniofacial program, with linkage to annual statewide abortion rates as a population-level contextual variable.Patients, Participants554 patients undergoing primary palatoplasty (1999 to 2021).InterventionsNone.Main Outcome Measure(S)Primary outcomes: annual Veau classification distribution. Secondary outcomes: prenatal diagnosis rates and genetic syndrome or sequence rates.ResultsFrom 2004 to 2021, the proportion of Veau I cases increased from 18.2% to 25.0% (slope β= + 0.0074 proportion-units/year; = .051), the proportion of Veau III cases declined significantly (slope β= -0.0085 proportion-units/year; = .011), and the proportion of Veau IV cases trended downward non-significantly. Higher abortion rates correlated with greater Veau III proportions (r = 0.63, = .005). Logistic regression demonstrated that each 1-SD increase in abortion rate raised severe-cleft odds by 26% (odds ratio (OR) 1.26; 95% CI 1.05-1.51; = .014), prenatal diagnosis (OR 13.13; < .001) and presence of genetic syndrome or sequence (OR 0.36; < .001) were also significant. Cleft severity decreased prior to 2010 (β = -0.11 units/year; = .036) and then plateaued. Prenatal diagnosis rates increased sevenfold during the study period.ConclusionsEnhanced prenatal detection and abortion rate shifts had minimal impact on live-birth CL/P trends. The paradoxical association between higher abortion rates and severe clefts suggests that reproductive decision-making is influenced by multifactorial factors beyond detection.
Outcomes Amidst Adversity: Socioeconomic Factors in Cleft Lip and Palate Care in the Southern United States.
Reese LT, Velazquez AE, Prezelski K … +2 more , Kane AA, Sanati-Mehrizy P
Cleft Palate Craniofac J · 2026 Jun · PMID 42227743 · Publisher ↗
ObjectiveTo evaluate socioeconomic and geospatial factors at a cleft care center in the Southern United States and assess their impact on outcomes in patients with cleft lip and/or palate (CLP).DesignRetrospective chart...
ObjectiveTo evaluate socioeconomic and geospatial factors at a cleft care center in the Southern United States and assess their impact on outcomes in patients with cleft lip and/or palate (CLP).DesignRetrospective chart review of patients with CLP, with stratification by neighborhood disadvantage using the University of Wisconsin's Area Deprivation Index (ADI). Univariate analyses compared quartiles.SettingA cleft care center in the Southern United States.Patients, ParticipantsInclusion criteria included children with CLP born between 2011 and 2022 who received the entirety of their care at the institution. Exclusion criteria were patients without CLP, those born before 2011, or those who did not complete care at the institution.InterventionsNo interventions were introduced.Main Outcome Measure(s)Associations between ADI quartiles and sociodemographic factors, appointment adherence, clinic presentation, hypernasality, and speech surgery incidence.ResultsSignificant associations were identified between the most disadvantaged quartile and others for ethnicity ( < .001), primary language ( = .013), insurance status ( = .001), and household income ( < .001). The most disadvantaged quartile had fewer cancellations ( = .002) and presented earlier ( = .050), but had higher rates of hypernasality ( = .005) and speech surgery ( = .046).ConclusionsPatients in the most disadvantaged quartile demonstrated strong adherence despite socioeconomic and linguistic barriers but had worse speech outcomes. Findings highlight opportunities to address linguistic and cultural barriers to improve cleft care.
Patient-Reported Outcomes Using the CLEFT-Q: Results from a Pilot Study of an Adult Cleft Lip and Palate Clinic.
O'Driscoll JA, Mcintyre G, Mossey P
Cleft Palate Craniofac J · 2026 Jun · PMID 42220266 · Publisher ↗
ObjectiveTo explore patient-reported outcomes using CLEFT-Q at a pilot adult cleft lip and palate (CLP) audit clinic.DesignCross-sectional study completed at two Dental Hospitals (Glasgow Dental Hospital and School and D...
ObjectiveTo explore patient-reported outcomes using CLEFT-Q at a pilot adult cleft lip and palate (CLP) audit clinic.DesignCross-sectional study completed at two Dental Hospitals (Glasgow Dental Hospital and School and Dundee Dental Hospital and Research School) and coinciding with a National Cleft Surgical Service's pilot CLP audit clinic.ParticipantsAdults who had primary surgery for orofacial cleft (OFC) performed in National Health Service Greater Glasgow and Clyde Health Board between 1990 and 2005.Main Outcome MeasureParticipants completed the validated CLEFT-Q scored 0-100, with higher scores reflecting better outcomes. Cleft lip (CL) and CLP scores were compared with Mann-Whitney U tests.ResultsThe response rate was 33% with 21 participants (14 female, 7 male) and a mean age of 21.9 ± 3.2 years (range 17-31 years). The sample included adults born with unilateral cleft lip (CL; n = 6), cleft palate (CP; n = 2), unilateral cleft lip and palate (UCLP; n = 8), and bilateral cleft lip and palate (BCLP; n = 5). Across cleft types, CLEFT-Q scores ranged from 36.0 ± 23.3 (Lips) to 93.0 ± 22.6 (Speech Distress) for adults with CL; from 28.5 ± 22.4 (Nostrils) to 75.4 ± 21.0 (Speech Distress) for adults with UCLP; and from 31.8 ± 26.5 (Nostrils) to 76.4 ± 18.7 (School) for adults with BCLP. There were no significant differences between adults with CL and those with CLP across the 12 CLEFT-Q scales.ConclusionIn this limited sample, scales of CLEFT-Q demonstrated a range of outcomes. The results provide baseline data for future research. Further work is needed to address residual concerns for adults with OFC.
Evaluating Two-Piece Le Fort I Osteotomy for Residual Alveolar Clefts: Case Series Highlighting Occlusal Outcomes and Radiographic Results.
Ren T, Steinberg JP, Yang R … +2 more , Shakoori P, Zinn IM
Cleft Palate Craniofac J · 2026 Jun · PMID 42220238 · Publisher ↗
ObjectivesTo assess the clinical and radiographic outcomes of segmental two-piece Le Fort I osteotomy in patients with cleft lip and palate (CLP) with residual alveolar clefts.DesignThis retrospective case series assesse...
ObjectivesTo assess the clinical and radiographic outcomes of segmental two-piece Le Fort I osteotomy in patients with cleft lip and palate (CLP) with residual alveolar clefts.DesignThis retrospective case series assessed the occlusal outcomes after Le Fort I osteotomy, and radiographic alveolar continuity using cone-beam computed tomography (CBCT).SettingTertiary cleft and craniofacial center within an academic institution.Patients/ParticipantsPatients aged ≥12 years with unilateral cleft lip and palate (UCLP) who presented with an anterior crossbite and residual alveolar defect and underwent orthodontic treatment and Le Fort I osteotomy between 2019 and 2025.InterventionsFour patients with UCLP underwent pre-surgical orthodontic treatment to prepare for orthognathic surgery. Extractions were performed to correct crowding and/or dental impactions. Patients then underwent Le Fort I osteotomies to correct the anterior crossbite and close the cleft gap.Main Outcome MeasuresCorrection of dental malocclusion and assessment of alveolar bone support of the residual alveolar cleft following segmental two-piece Le Fort I osteotomy.ResultsIn all cases, anterior crossbite was corrected to positive overjet with normal overbite. Results were well accepted by all patients. Size of cleft defects was reduced with radiographic evidence of osseous continuity. The need for prosthodontic replacement teeth was eliminated in each case.ConclusionsAll four patients who underwent orthodontic treatment and segmental two-piece Le Fort I osteotomy resulted in corrected the anterior crossbite and closure of the cleft gap. Patients underwent several extractions to ensure that the remaining teeth were centered in alveolar bone, and their final occlusion was functional and stable.
Hearing and Otologic Outcomes After Routine Versus Selective Ventilation Tube Insertions in Children With Cleft Palate: A Retrospective Cohort Study.
Bachini S, Lodder W, Breugem C … +1 more , Moues-Vink C
Cleft Palate Craniofac J · 2026 May · PMID 42213516 · Publisher ↗
ObjectiveThis study compares audiologic and otologic outcomes of routine and selective ventilation tube insertion (VTI) performed during palatoplasty.DesignRetrospective cohort.SettingCleft Team North, location Leeuwarde...
ObjectiveThis study compares audiologic and otologic outcomes of routine and selective ventilation tube insertion (VTI) performed during palatoplasty.DesignRetrospective cohort.SettingCleft Team North, location Leeuwarden, Oral Clefts Referral Center.Patients, ParticipantsChildren with cleft palate, with or without cleft lip and/or alveolar involvement (CP ± L).InterventionsVTI was performed concurrently with palatoplasty at 9-10 months of age. Until 2019, VTI was routinely performed. Under the new protocol introduced thereafter, VTI is only performed at the time of palatoplasty if previously indicated based on audiologic and ear, nose, and throat (ENT) evaluation conducted at 8 months of age.Main Outcome Measure(s)Data were collected from medical records and included audiologic and ENT assessments before and after VTI, frequency of otorrhea, re-tympanostomy, and otologic complications such as persistent perforation, cholesteatoma, and tympanosclerosis. A uniform follow-up period of 2 years was implemented for all participants in both groups to enable a consistent comparison over time.ResultsForty-one children with CP ± L were included: 21 received VTI during palatoplasty under the routine protocol, and 20 were managed under the selective protocol. Of the latter, 17 were indicated for VTI at the time of surgery, while 2 of the 3 initially not indicated required VTI during follow-up. No significant differences were observed between groups in re-tympanostomy rates, hearing outcomes, or surgical complications.ConclusionsRoutine VTI appears to be necessary in children with CP ± L. Furthermore, ENT clinical examination alone may suffice for VTI indication, reducing unnecessary audiologic assessments and therefore lowering the burden of care without compromising quality of care.
Comparative Analysis of Hospital Charges in Infants With Robin Sequence: Nonsurgical Orthodontic Airway Plate Versus Surgical Mandibular Distraction.
Krakauer KN, Forrest CR, Park JY … +7 more , Zhang J, Olivares M, Ly M, Komondor K, Lorenz PH, Wan DC, Choo H
Cleft Palate Craniofac J · 2026 May · PMID 42213477 · Publisher ↗
ObjectiveTo compare hospital charges associated with 2 airway treatments in infants with Robin sequence (RS)DesignRetrospective cohort study.SettingSingle quaternary pediatric hospital.PatientsInfants with RS admitted fo...
ObjectiveTo compare hospital charges associated with 2 airway treatments in infants with Robin sequence (RS)DesignRetrospective cohort study.SettingSingle quaternary pediatric hospital.PatientsInfants with RS admitted for treatment between January 2016 and April 2023InterventionsNonsurgical Stanford orthodontic airway plate (OAP) or surgical mandibular distraction osteogenesis (MDO)Main Outcome MeasuresHospital charges from admission to discharge, categorized and inflation-adjusted to 2024 United States DollarsResultsThirteen OAP-treated and nine MDO-treated infants were included. All infants were discharged home. Median age (minimum, maximum) at index admission was 38 days (1, 89) in OAP and 18 days (1, 65) in MDO. Median total hospital stay was 15 days (8, 26) in OAP and 23 days (12, 40) in MDO ( = 0.003). This included intensive care unit (ICU) stays of 3 days (0, 6) in OAP and 14 days (4, 21) in MDO ( < 0.001). Median total inflation-adjusted hospital charges were significantly lower in OAP ($683,549.20; interquartile range (IQR): $567,075.90 - $821,018.30) compared to MDO ($1,269,670.00; IQR: $932,087.50 - $1,573,712.00; = 0.006), representing a 46.2% reduction. Non-ICU stay, ICU stay, and professional services were the top three contributors to the total hospital charges in OAP, while ICU stay, non-ICU stay, and operating room utilization were those in MDO during index admission.ConclusionsNonsurgical OAP has the potential to reduce hospital charges and accelerate the transition home compared to MDO, serving as a high-value treatment modality for optimizing both clinical outcomes and hospital resource allocation.
Impact of Muscular Asymmetry on Velopharyngeal Function in Children with Craniofacial Microsomia: A Pilot Study.
Kotlarek KJ, Moriarty M, Kinter S
Cleft Palate Craniofac J · 2026 May · PMID 42204841 · Publisher ↗
ObjectiveTo quantify the morphology and asymmetry of the levator veli palatini (LVP) muscle in children with craniofacial microsomia (CFM) and explore associations with velopharyngeal insufficiency (VPI).DesignRetrospect...
ObjectiveTo quantify the morphology and asymmetry of the levator veli palatini (LVP) muscle in children with craniofacial microsomia (CFM) and explore associations with velopharyngeal insufficiency (VPI).DesignRetrospective cohort study.SettingPediatric tertiary care center.Patients, ParticipantsTwenty children with CFM who underwent clinically indicated head and neck MRI.Main Outcome MeasuresLVP left-right asymmetry, midline velopharyngeal measures, and presence of VPI.ResultsThree participants (15%) had VPI. Significant left-right asymmetry was observed for total LVP length, LVP thickness at velar insertion, and angle of origin ( ≤ .05). Greater differences between most and least affected sides in total LVP length were associated with lower VPI prevalence (PR, 0.58 per 1-mm increase; 95% CI, 0.36-0.93; = .02). Greater pharyngeal depth predicted higher VPI prevalence (PR, 1.35 per 1-mm increase; 95% CI, 1.07-1.70; = .01), while increased midline LVP thickness was associated with lower prevalence (PR, 0.76 per 1-mm increase; 95% CI, 0.65-0.90; = .01).ConclusionChildren with CFM demonstrate significant asymmetry of the LVP muscle. Shorter total LVP length, thinner midline LVP, and greater pharyngeal depth were associated with higher VPI prevalence, indicating a need for prospective studies to clarify the role of soft-tissue variation in velopharyngeal function.
Experiences of Parents Expecting a Child with a Cleft: A Qualitative Interview Study into Healthcare Provision and Parental Concerns.
van Veen-van der Hoek M, Meuldijk R, Okkerse J … +3 more , Go A, Wolvius E, Van Dalen M
Cleft Palate Craniofac J · 2026 May · PMID 42203523 · Publisher ↗
ObjectiveHaving a child with a cleft lip with or without palate (CL ± P) can greatly impact parents' lives. Retrospective studies have shown that receiving a CL ± P diagnosis is an emotional event, requiring considerable...
ObjectiveHaving a child with a cleft lip with or without palate (CL ± P) can greatly impact parents' lives. Retrospective studies have shown that receiving a CL ± P diagnosis is an emotional event, requiring considerable adjustment. However, there has been limited prospective research on how parents experience pregnancy when faced with a prenatal diagnosis of CL ± P. This study aims to examine the experiences of parents during pregnancy, focusing on their concerns and perspectives regarding cleft care, pregnancy, childbirth, and upbringing.DesignParticipants were interviewed between 24 to 39 weeks of gestational age using semi-structured interviews. Data were analyzed using inductive reflexive thematic analysis.SettingInterviews took place through a videocall, a phone call or face-to-face, following participants' preferences. Interviews lasted an average of 33 min.ParticipantsEleven expectant mothers and 8 expectant fathers were recruited from the cleft team at a university medical center.ResultsFour main themes were identified: "Suspected diagnosis: An emotional rollercoaster," "After diagnosis: So much information and healthcare professionals," "No carefree pregnancy," and "What will the future bring?". Receiving a prenatal CL ± P diagnosis was experienced as an emotional rollercoaster, accompanied by numerous uncertainties. Parents reported that the cleft care trajectory did not always optimally support them in emotionally processing the diagnosis.ConclusionsResults highlight a need for specialized cleft care tailored to parental needs and wishes. Specifically, empathetic reactions of healthcare providers are crucial, as well as an additional contact moment for parents before childbirth.
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