Cleft Palate Craniofac. J. [JOURNAL]
Sun
200 papers
Evaluating 3D Morphometrics for Assessing Micrognathia in Neonates with Severe Pierre Robin Sequence: A Case-Control Study.
Bhatia SS, Hung PW, Velazquez AE … +6 more , Prezelski K, Harrison LM, Booth T, Hallac RR, Kane AA, Sanati-Mehrizy P
Cleft Palate Craniofac J · 2026 Mar · PMID 41891204 · Publisher ↗
ObjectiveTo compare 3D mandibular morphometrics of neonates with Pierre Robin sequence (PRS) to age-matched controls, establish normative data, and better understand anatomic differences.DesignRetrospective case-control...
ObjectiveTo compare 3D mandibular morphometrics of neonates with Pierre Robin sequence (PRS) to age-matched controls, establish normative data, and better understand anatomic differences.DesignRetrospective case-control study.SettingTertiary pediatric medical center.PatientsTwenty-five neonates with non-syndromic PRS (mean age 15 days) with computed tomography (CT) scans of the head and mandibular distraction osteogenesis (MDO) and 25 age-matched controls (mean age 14 days) with CT scans of the head.InterventionsNone.Main Outcome MeasuresStandardized morphometric measurements, including linear distances, angles, and ratios, were generated from digital 3D reconstructions of mandibular anatomy.ResultsAsymmetry in PRS body length was significantly higher than in control mandibles ( = .006). PRS measurements larger than control measurements included intercondylar distance ( = .044), intergonial distance ( = .008), pogonion-interdental distance ( = .015), ramus height ( = .001), and ramus height to body length ratio ( < .001). PRS measurements smaller than control measurements included intercondylar angle ( < .001), body length ( < .001), and effective mandibular length ( < .001).ConclusionsIn a cohort of neonates with PRS severe enough to warrant MDO, findings indicate that micrognathia is constituted by a wide and antero-posteriorly short mandible for its height. Except for body length, PRS and control mandibles are similarly asymmetrical in other dimensions. These findings may contextualize structural abnormalities contributing to glossoptosis and airway obstruction in PRS, with implications for surgical management, although decision-making remains primarily guided by clinical severity of airway obstruction.
Randomized Controlled Trial Comparing Resorption Rates of Mandibular Cortical and Iliac Cancellous Bone Grafts in Alveolar Cleft Repair.
Pang X, Zhao X, Yu Z … +2 more , Wang H, Cai M
Cleft Palate Craniofac J · 2026 Mar · PMID 41877620 · Publisher ↗
ObjectiveThe main objective of the randomized controlled trial (RCT) was to evaluate the short-term osteogenic effects of mandibular cortex bone (MCB) versus iliac cancellous bone (ICB) after secondary alveolar bone graf...
ObjectiveThe main objective of the randomized controlled trial (RCT) was to evaluate the short-term osteogenic effects of mandibular cortex bone (MCB) versus iliac cancellous bone (ICB) after secondary alveolar bone graft.DesignRCT.SettingDepartment of Oral and Cranio-Maxillofacial Surgery in the Shanghai Ninth People's Hospital from September 1, 2020, to August 31, 2023.PatientsPatients with unilateral alveolar cleft.InterventionsThose who met the inclusion criteria were randomly assigned to receive either MCB or ICB grafting. Clinical and radiographic examinations were performed preoperatively and immediately, as well as at 1, 3, 6, 12, 18, and 24 months postoperatively.Main Outcome Measure(s)The bone resorption rate was measured 6 months postoperatively. Clinical observations included adverse events and hospitalization details including length of surgery, intraoperative bleeding, length of stay, and costs.ResultsA total of 28 patients were included, with 16 allocated to the MCB group and 12 to the ICB group. The bone resorption rate in the MCB group (45.20 ± 29.81%) was significantly lower than that in the ICB group (74.87 ± 18.48%) (P = 0.005). Two adverse events were reported in the MCB group. The MCB group had significantly greater costs (P < 0.001), a significantly shorter length of stay (P < 0.001), and a significantly longer duration of surgery (P = 0.026). However, there were no significant differences in terms of intraoperative bleeding.ConclusionCompared with ICB, MCB demonstrated a slower bone resorption rate in the short term for treating secondary alveolar cleft in this study, albeit with increased surgical time and costs.Trial RegistrationRegistry number: ChiCTR2000034227 [URL: https://www.chictr.org.cn/showprojEN.html?proj=55737].
Invited Sessions at ACPA's 2026 Annual Meeting.
Cleft Palate Craniofac J · 2026 Mar · PMID 41874632 · Publisher ↗
Abstract loading — click title to view on PubMed.
Longitudinal Speech Outcomes in Foreign-Born and Native-Born Children in Sweden with Cleft Palate, and Influence of Palatal Surgery Timing.
Lendt L, Becker M, Andersson K … +1 more , Klintö K
Cleft Palate Craniofac J · 2026 Mar · PMID 41869767 · Publisher ↗
ObjectiveTo compare longitudinal speech outcomes at ages 5 and 10 years in foreign-born and Swedish-born children with cleft palate with or without cleft lip (CP ± L), and assess impact of cleft type, additional diagnose...
ObjectiveTo compare longitudinal speech outcomes at ages 5 and 10 years in foreign-born and Swedish-born children with cleft palate with or without cleft lip (CP ± L), and assess impact of cleft type, additional diagnosed conditions, sex, and age at completed primary palatal surgery.DesignLongitudinal, registry-based cohort study.SettingRegional public care university hospitals in Sweden.Participants723 children (143 foreign-born, 580 Swedish-born) with CP ± L.InterventionsPrimary and secondary palatal surgery, and speech-language therapy.Main outcome measuresDichotomized outcomes of velopharyngeal competence (VPC), percentage of consonants correct (PCC), and non-oral speech errors, and received secondary palatal surgery and speech-language therapy.ResultsA significantly lower proportion of foreign-born than Swedish-born 5-year-olds had VPC (75% vs. 85%, = .007), age-appropriate consonant production (25% vs. 57% < .001), and no non-oral speech errors (67% vs. 84%, < .001). Speech improved longitudinally, yet a significantly lower proportion of foreign-born children had VPC (86% vs. 94%, = .002), age-appropriate consonant production (52% vs. 76%, < .001), and no non-oral errors (82% vs. 93%, < .001) at 10 years. The difference in VPC at age 5 and in all speech outcomes at age 10 was associated with higher age at primary surgery in foreign-born children. They also had higher rates of secondary palatal surgery ( < .001) and speech-language therapy ( < .001) than Swedish-born peers.ConclusionsLater primary palatal surgery in foreign-born children was associated with poorer speech outcomes at 10 years. Early primary palatal surgery and continued follow-up are essential to optimize speech development.
The Relationship Between Parent and Child Anxiety: Testing the Intergenerational Model of Anxiety in Children Born with a Cleft.
Button R, McFarlane F, Farrington A … +1 more , Hotton M
Cleft Palate Craniofac J · 2026 Mar · PMID 41869757 · Publisher ↗
ObjectiveTo compare overprotective parenting and child and parent anxiety between children born with and without a cleft lip and/ or palate (CL/P). To understand correlates of anxiety for children born with a CL/P and th...
ObjectiveTo compare overprotective parenting and child and parent anxiety between children born with and without a cleft lip and/ or palate (CL/P). To understand correlates of anxiety for children born with a CL/P and their parents.Design, Participants, SettingParents of 8- to 12-year-old children with a CL/P ( = 63, mean age = 10.5 years, male = 68.3%), or without a CL/P (control group; = 66, mean age = 9.9 years, male = 47%) were recruited from the UK community (2022-2024). Most respondents were mothers (92.2%).Outcome measuresParents completed an online survey assessing overprotective parenting, child anxiety, parent anxiety, and (in the CL/P group) parental appraisals.ResultsParent-reported child anxiety was higher in the CL/P group than the control group (η = 0.04, = .03), while parent anxiety (η = 0.01, = .26) and overprotective parenting (η = 0.001, = .73) did not differ significantly between groups. Within the CL/P group, parent-reported child anxiety was associated ( < .05) with parental anxiety ( = .27), overprotective parenting ( .38), and certain parental appraisals (child's self-confidence; .45, and manageability of the CL/P; -.25). Parent anxiety was associated with overprotective parenting ( = .40), and self-blame appraisals ( .37).ConclusionsChildren born with a CL/P may be at increased risk of anxiety by parent-report, while parental anxiety and overprotection appear comparable to controls. Parental appraisals may be promising targets for intervention. Future longitudinal research is required to draw causal inferences.
Enhanced Recovery After Surgery Protocols Can Vastly Decrease Rates of Outpatient Opiate Prescribing in Pediatric Plastic Surgery Patients.
Morin SD, Fernstrum C, Dhungel L … +2 more , Humphries LS, Hoppe IC
Cleft Palate Craniofac J · 2026 Mar · PMID 41841363 · Publisher ↗
ObjectiveThis study analyzes pediatric plastic surgery outpatient opioid prescribing rates at a single institution that implemented Enhanced Recovery After Surgery (ERAS) protocols with the national average.DesignA retro...
ObjectiveThis study analyzes pediatric plastic surgery outpatient opioid prescribing rates at a single institution that implemented Enhanced Recovery After Surgery (ERAS) protocols with the national average.DesignA retrospective analysis was performed using the 2023 ACS NSQIP Pediatric Opioid Stewardship Report.Setting:The study was conducted at a single academic pediatric hospital participating in the ACS NSQIP Pediatric registry.Patients/ParticipantsPediatric patients who underwent common plastic surgery procedures between January 1 and December 31, 2023, as reported by NSQIP, were included. This comprised 146 patients from the study institution and 10 557 patients from 157 other NSQIP-participating hospitals.InterventionsERAS protocols emphasizing non-opioid multimodal analgesia were implemented in 2018. No outpatient opioids were prescribed for cleft lip repair, cranial spring placement/removal, or mandibular distraction osteogenesis. For more invasive procedures, patients received 3 doses of oral oxycodone.Main Outcome Measure(s)The primary outcome is the rate of outpatient opioid prescribing at the study institution compared to the national average, stratified by age group (adolescents, children, infants/small children, and neonates).ResultsThe study institution had a significantly lower prescribing rate (10.96%) versus the national average (51.81%) ( < .000001). By age group: adolescents (23.81% vs 63.20%), children (5.88% vs 52.82%), and infants/small children (6.45% vs 45.85%), all < .000001. No neonates at the study site received opioids, compared to 13.83% nationally ( = .566).ConclusionsERAS protocol implementation is associated with a significant reduction in outpatient opioid prescribing. Broader adoption may improve opioid stewardship in pediatric plastic surgery.
Does the Rigid External Distraction Device Allow for Long-Term Control of Maxillary Pitch in Cleft Maxillary Distraction?
Mathews AT, Kinard BE
Cleft Palate Craniofac J · 2026 Mar · PMID 41834649 · Publisher ↗
ObjectiveIt has been reported that the rigid external distraction (RED) device is unable to intentionally alter the maxillary pitch following consolidation (short term). The purpose of this study is to assess the long-te...
ObjectiveIt has been reported that the rigid external distraction (RED) device is unable to intentionally alter the maxillary pitch following consolidation (short term). The purpose of this study is to assess the long-term ability of RED to intentionally control the maxillary pitch.DesignRetrospective cohort study.SettingInstitutional practice.PatientsA retrospective cohort of 40 patients with cleft maxillary hypoplasia meeting the inclusion criteria.Main outcome measuresCephalometric changes and alteration in palatal plane angle.MethodsCephalometric analysis was completed standardized lateral cephalograms. Predistraction and long-term follow-up variables were compared via a paired test.ResultsThe mean age at surgery of 12.2 ± 3.7 years. Through distraction osteogenesis, the mean change in the angles sella-nasion-A-point angle, sella-nasion-B point angle, and A-point-nasion-B-point angle were 4.8 ± 5.9, 2.4 ± 3.5, and 2.4 ± 5.4, respectively. The mean change in the palatal plane angle was -2.1 ± 4.7. The mean change in the vertical position of the anterior nasal spine and posterior nasal spine in relation to the Frankfort horizontal were -0.7 ± 4.0 mm and 0.9 ± 4.1 mm, respectively. The mean percent of maxillary advancement relative to maxillary length was 28.0 ± 12.1%.ConclusionThis study documents the long-term findings of RED in a cleft lip and palate population. Despite the design of the RED device to allow for a clockwise rotation of the maxilla, a persistent counterclockwise rotation of the maxilla was found. This study demonstrates that RED reliably allows for long-term horizontal lengthening of the maxilla but does not predictably allow for control of the maxillary occlusal plane.
Cleft Lip and Palate is Common in PORCN-Related Focal Dermal Hypoplasia in Asians: Three New Case Reports and Literature Review.
Chan JCK, Wu PKW, Yiu WC … +2 more , Ho SKL, Luk HM
Cleft Palate Craniofac J · 2026 Mar · PMID 41834648 · Publisher ↗
Focal dermal hypoplasia is an X-linked dominant genetic disorder predominantly affecting females, caused by loss-of-function variants in the gene, characterized by ectodermal, skeletal, craniofacial and ocular structura...
Focal dermal hypoplasia is an X-linked dominant genetic disorder predominantly affecting females, caused by loss-of-function variants in the gene, characterized by ectodermal, skeletal, craniofacial and ocular structural abnormalities. We report three cases with novel variants, and performed a comprehensive review of the clinical features of this disorder focusing on Asian patients, and identified significant differences compared with previous literature focusing on Caucasian patients. Cleft lip and palate is a frequently reported feature in Asian patients, but not in Caucasians. This improves the understanding of this rare disease in particular ethnic-specific differences.
What We Learnt in Unilateral Cleft Lip Repair Between Millard's and Tennison-Randall's Techniques: Comparison of the Outcomes in Adult Patients.
Pistoia A, Rizzo MI, Grippaudo FR … +5 more , Cajozzo M, Grussu F, Molinaro F, Nascimben F, Zama M
Cleft Palate Craniofac J · 2026 Mar · PMID 41823249 · Publisher ↗
ObjectiveTo compare long-term esthetic and morphological outcomes of unilateral cleft lip (UCL) repair using the Millard rotation-advancement versus the Tennison-Randall triangular flap technique, testing whether Millard...
ObjectiveTo compare long-term esthetic and morphological outcomes of unilateral cleft lip (UCL) repair using the Millard rotation-advancement versus the Tennison-Randall triangular flap technique, testing whether Millard provides superior lip symmetry.DesignRetrospective cohort study.SettingSingle tertiary cleft center.Patients, ParticipantsForty adults aged 18-25 were selected from 168 patients treated between 1988 and 1995. Inclusion criteria: complete UCL, primary cheiloplasty, absence of secondary lip revisions, complete frontal photographic documentation, and no syndromic diagnoses. Twenty underwent Millard repair and twenty Tennison-Randall repair.InterventionsPrimary UCL reconstruction performed using either Millard rotation-advancement or Tennison-Randall triangular flap. All operations were carried out by the same senior cleft surgeon under comparable operative conditions.Main Outcome Measure(s)Long-term lip symmetry quantified through a Symmetry Index derived from predefined anthropometric landmarks on standardized images. Subjective esthetic satisfaction assessed using the esthetic Units Satisfaction Questionnaire and the Cleft esthetic Rating Scale, completed by patients, the operating surgeon, and a blinded observer.ResultsMillard repair showed significantly greater medial lip width symmetry ( = .014). No significant differences were found for vermilion height, prolabial height, lateral lip width, or lip area. Subjective assessments consistently favored Millard, showing higher satisfaction and fewer negative ratings. Inter-rater reliability across evaluators was high (ICC = 0.82).ConclusionsBoth techniques produced stable long-term outcomes, but Millard yielded superior medial lip symmetry and higher esthetic satisfaction. These findings support its continued clinical preference and highlight the importance of long-term evaluations. Larger prospective studies are needed to confirm these results.
What Are the Challenges Facing Comprehensive Cleft Care in Africa? A Qualitative Study Involving Cleft Care Providers Across Africa.
Isiekwe IG, Batra P
Cleft Palate Craniofac J · 2026 Mar · PMID 41823231 · Publisher ↗
ObjectiveTo identify the challenges facing comprehensive cleft care in Africa and to propose solutions to some of these challengesDesignA virtual focus group discussion (FGD) was conducted involving 10 cleft care provide...
ObjectiveTo identify the challenges facing comprehensive cleft care in Africa and to propose solutions to some of these challengesDesignA virtual focus group discussion (FGD) was conducted involving 10 cleft care providers from across the African continent. Thematic analysis was used to analyze the collected data.SettingParticipants in the FGD were experienced cleft care providers from across Africa including North Africa, Southern Africa, East Africa, West Africa, Central Africa and a representative of Francophone West Africa.ParticipantsTen experienced cleft care providers from across the African continent, who were selected using a purposive sampling technique, based on their specialty and experience in cleft care.Main outcome measuresChallenges facing comprehensive cleft care in Africa were identified and solutions proffered to some of these challenges.ResultsThe main challenges and solutions were categorized under patients' factors, clinicians' factors and institutional/other factors. Poverty, low level of awareness, insufficient manpower and poor healthcare systems were some of the major recurring challenges. Other unique challenges identified were language barriers affecting access to cleftcare training in Francophone Africa and the brain drain syndrome, which had resulted in the migration of cleftcare manpower from the continent. Improved patient support systems, enhanced manpower training and motivation and improved healthcare systems were some of the solutions suggestedConclusionThe main challenges identified were shortage of required manpower and institutional and policy challenges, while the proposed solutions ranged from enhanced manpower training and motivation to improved healthcare systems.
Suprazygomatic Maxillary Nerve Block is Associated with Reduced Postoperative Inpatient Opioid Requirement in Patients Undergoing Palatoplasty.
Manasyan A, Donaldson R, Naidu P … +4 more , Nayeri D, Urata MM, Hammoudeh JA, Magee WP
Cleft Palate Craniofac J · 2026 Mar · PMID 41816831 · Publisher ↗
ObjectiveThe objective of this study was to evaluate the efficacy of the suprazygomatic maxillary nerve block in reducing postoperative inpatient opioid requirements in patients undergoing palatoplasty for cleft palate r...
ObjectiveThe objective of this study was to evaluate the efficacy of the suprazygomatic maxillary nerve block in reducing postoperative inpatient opioid requirements in patients undergoing palatoplasty for cleft palate repair.DesignRetrospective cohort studySettingTertiary care children's hospitalPatients, ParticipantsPatients with isolated cleft palate or cleft lip and palate who underwent palatoplasty at our institution between 2006 and 2025.InterventionsPatients who received the suprazygomatic maxillary nerve block and a controlled cohort of patients who underwent cleft palate repair during the same time period without receiving a nerve block were assessed. Patient demographics, perioperative data, and opioid requirements within the immediate eight hours (in morphine milliequivalents [MME]) following surgery were recorded. Multivariate regression analysis was performed, with significance defined as < .05.Main Outcome MeasuresInpatient opioid requirement eight hours following surgeryResultsA total of 470 patients were included, with 235 (50.0%) in the nerve block group and 235 (50.0%) in the group without nerve block. When adjusting for age, sex, Veau class, and surgical approach, use of nerve block was associated with a significantly lower amount of MME administered in the first eight hours following palatoplasty (OR = 0.54, 95% CI [0.34-0.87], = .011).ConclusionsThe suprazygomatic maxillary nerve block appears to be an effective technique for reducing postoperative inpatient opioid requirements in children undergoing cleft palate repair.
Comparison of Dental Relationship and Craniofacial Development in Children With Unilateral Cleft Lip and Palate Treated With/Without Presurgical Nasoalveolar Molding.
Zheng J, Ren M, Yang Z … +3 more , Sun Y, Guo D, Yuan W
Cleft Palate Craniofac J · 2026 Mar · PMID 41816816 · Publisher ↗
ObjectiveTo evaluate long-term effects of presurgical nasoalveolar molding (PNAM) on occlusal relationships and craniofacial development in children with unilateral cleft lip and palate (UCLP) using the 5-year-olds' inde...
ObjectiveTo evaluate long-term effects of presurgical nasoalveolar molding (PNAM) on occlusal relationships and craniofacial development in children with unilateral cleft lip and palate (UCLP) using the 5-year-olds' index and cone-beam computed tomography (CBCT).DesignRetrospective cohort study.SettingTertiary-level Class A specialized stomatological hospital.ParticipantsSixty-four patients with complete UCLP.InterventionsThirty patients underwent PNAM treatment, and 34 patients did not.Main Outcome MeasureCBCT scans were used to assess dental occlusion via the 5-year-old index and to measure craniofacial variables. Intergroup differences were analyzed using the Mann-Whitney test and the chi-square test, while the correlation between occlusion and craniofacial variables was examined using the Pearson correlation coefficient. A value of less than .05 was considered statistically significant.ResultsA comparison of 5-year-olds' index scores in the two groups showed median scores of 3.0 (PNAM group) and 3.5 (non-PNAM group), respectively, with no significant difference found. For prognosis, no significant difference in orthognathic surgery need was found, but the PNAM group had a higher nonsurgery rate (60%) versus 50% in the non-PNAM group. In craniofacial development, the PNAM group had significantly longer maxillary length; favorable prognosis group showed smaller SNB angles, shorter mandibular body, larger ANB angles, and longer maxillary length. Correlation analysis showed 5-year-olds' index positively correlated with SNB/mandibular body length, and negatively with ANB/maxillary length.ConclusionsEarly childhood evaluations showed that treatment with/without PNAM in the neonatal period was not a major factor influencing occlusal relationships or craniofacial development in patients with UCLP. Furthermore, correlation between 5-year-olds' index and skeletal morphology in children with UCLP has been confirmed.
Prevalence of Malnutrition in Children with Cleft Conditions in Madagascar: A Cross-Sectional Study.
Otobo DD, Steppling C, Myles A … +4 more , Torres N, Jones EM, Dwyer A, Yao C
Cleft Palate Craniofac J · 2026 Mar · PMID 41784073 · Publisher ↗
ObjectiveThis study aims to assess the prevalence, patterns, and distribution of malnutrition among pediatric patients evaluated for cleft surgery in Madagascar.MethodologyDesign/Setting: This Retrospective cross-section...
ObjectiveThis study aims to assess the prevalence, patterns, and distribution of malnutrition among pediatric patients evaluated for cleft surgery in Madagascar.MethodologyDesign/Setting: This Retrospective cross-sectional study assessed 658 patients who presented for cleft care between 2020 and 2023 during surgical programs of an International Cleft Surgical Non-Profit Organization in Madagascar.Intervention/Outcome MeasuredPatient demographics and anthropometry of all patients were measured. The weight-for-length score/weight-for-height score World Health Organization Growth Chart scores, as well as mid-upper arm circumference for patients aged > 6 months to 59 months, were measured and recorded. Patients were grouped based on gender and age.ResultsOf the 658 patients screened for surgery, 96% were malnourished (mild to severe malnutrition), and 83% of the screened patients had to be enrolled in the nutrition program ( scores ≤ -2standard deviation) for nutritional optimization before surgery could be considered. At the time of this study, 239 patients had received surgery, while 309 were awaiting surgery. The majority had combined cleft lip and palate (59%), and over half of the mothers were unable to breastfeed their children at all due to the cleft condition(s) (53%). The highest prevalence (52.4%) and severity (68.1%) of malnutrition was observed among infants under 6 months old.ConclusionThe malnutrition status among patients with a cleft lip and/or palate in Madagascar is high (96%, < .001). When children with cleft conditions who were malnourished (96%) were compared with the under-5 malnutrition status among non-cleft patients (47%) in Madagascar, it was a ratio of 2:1.
Simultaneous Orthognathic Surgery and Costal Bone Grafting in Hemifacial Microsomia: A Rare Case Report and Literature Review.
Lee CH, Lee HS, Choi YK … +4 more , Lo LJ, Jung SY, Denadai R, Seo HJ
Cleft Palate Craniofac J · 2026 Mar · PMID 41773628 · Publisher ↗
Hemifacial microsomia (HFM) is a congenital craniofacial anomaly frequently associated with mandibular hypoplasia. Achieving stable correction in severe cases remains challenging due to abnormal mandibular anatomy and de...
Hemifacial microsomia (HFM) is a congenital craniofacial anomaly frequently associated with mandibular hypoplasia. Achieving stable correction in severe cases remains challenging due to abnormal mandibular anatomy and deficient temporomandibular joint structures. We report a rare revision case of a 20-year-old female with type IIA HFM who developed progressive postoperative resorption following two-jaw surgery, resulting in a "floating" ramus-condyle segment and subsequent recurrent facial asymmetry. Revision surgery consisted of unilateral sagittal split ramus osteotomy on the unaffected side, combined with long-plate fixation and costal bone grafting on the affected side. A distal portion of the harvested costal bone was trimmed and vertically split into smaller fragments and interposed as free bone grafts between the proximal and distal mandibular segments, while the main portion was applied laterally as an onlay graft. Postoperative follow-up confirmed preservation of mandibular height with an acceptable occlusion, and secondary fat grafting further refined the soft-tissue contour. This case suggests that integrating orthognathic surgery with autogenous bone grafting may provide a durable solution in complex revision scenarios. It also highlights the importance of individualized planning and combined skeletal-soft tissue approaches to achieve favorable aesthetics.
Special Issue Introduction: 2026 Spotlight on Early-Career Researchers of the American Cleft Palate-Craniofacial Association.
Kotlarek KJ, Cray JJ
Cleft Palate Craniofac J · 2026 Mar · PMID 41769782 · Publisher ↗
This second special issue of highlights early career researchers and their novel contributions to the interdisciplinary field of cleft and craniofacial science and care. These 16 manuscripts span clinical and basic scie...
This second special issue of highlights early career researchers and their novel contributions to the interdisciplinary field of cleft and craniofacial science and care. These 16 manuscripts span clinical and basic science, reflecting the journal's commitment to evidence-based, team-centered care and promoting the work of those early in their careers. This year's showcase also highlights the emerging trends in digital innovation, patient-centered language and outcomes, and advances in interdisciplinary and translational science.
Morphological Changes Occur in the Brains of Children With Non-Syndromic Cleft Lip and Palate After Speech Therapy.
Zhai Y, Zheng X, Liang S … +1 more , Chen R
Cleft Palate Craniofac J · 2026 Feb · PMID 41762165 · Publisher ↗
ObjectiveThe purpose of this study was to investigate the effect of speech therapy on cerebral morphology in patients with non-syndromic cleft palate with or without cleft lip (NSCP ± L) related articulation disorders us...
ObjectiveThe purpose of this study was to investigate the effect of speech therapy on cerebral morphology in patients with non-syndromic cleft palate with or without cleft lip (NSCP ± L) related articulation disorders using structural magnetic resonance imaging technology.DesignA prospective pre-post intervention study.SettingThis study was conducted in the Department of Oral and Maxillofacial Surgery and the Medical Imaging Center of a tertiary hospital.Patients/ParticipantsA total of 24 children with NSCP ± L, aged 6-16 years, who had undergone cleft palate surgery but still presented with articulation disorders.InterventionsThese patients received standardized speech therapy and were divided into the before therapy scans group (bTherapy Scans) and after therapy scans group (aTherapy Scans). By using high-resolution T1-weighted cerebral magnetic resonance imaging scans.Main Outcome Measure(s)Cerebral gray matter volume (GMV), cortical thickness (CT), fractal dimension (FD), and sulcus depth (SD).ResultsCompared with the bTherapy Scans, the aTherapy Scans showed a significant increase in GMV in the left middle frontal gyrus and left medial orbital frontal lobe; a significant increase in CT and FD in the left rostral middle frontal gyrus; and a significant increase in SD in the right lateral orbital frontal lobe region.ConclusionsSpeech therapy not only effectively improves the articulatory function of children with NSCP ± L-related speech disorders, but its effects may also be associated with structural remodeling of brain regions related to speech motor planning and emotional regulation.
Screening for Obstructive Sleep Apnoea in Patients With Cleft Lip and/or Palate in Saudi Arabia.
Alassaf MS, Abdulhameed FD, Othman AA … +5 more , Khaja H, Habeeb AT, Alolayan AB, Alsulaimani MA, Hakeem FF
Cleft Palate Craniofac J · 2026 Feb · PMID 41757857 · Publisher ↗
ObjectiveTo screen for obstructive sleep apnea (OSA) in nonsyndromic patients with cleft lip and/or palate in Saudi Arabia and to identify factors associated with positive OSA screening results.DesignCross-sectional anal...
ObjectiveTo screen for obstructive sleep apnea (OSA) in nonsyndromic patients with cleft lip and/or palate in Saudi Arabia and to identify factors associated with positive OSA screening results.DesignCross-sectional analytical study.SettingCleft lip and palate clinic, Madinah, Saudi Arabia.Patients, ParticipantsA total of 231 nonsyndromic patients aged 2 to 18 years with cleft lip and/or palate. Patients with syndromic diagnoses were excluded.InterventionsParticipants and their guardians completed a structured, 37-item interview-based questionnaire administered by the investigator. Responses were recorded through an online form and analyzed after data cleaning.Main Outcome Measure(s)Screening outcomes for OSA risk and associations between OSA status and demographic or clinical variables.ResultsThe mean age of participants was 7.5 ± 3.7 years, and 55.4% were male. Most patients were underweight (70%), followed by those with healthy body mass index (21.2%). No significant differences were found between OSA-positive and OSA-negative groups across demographic or clinical variables, except for the OSA risk score, which was significantly higher in the OSA-risk group.ConclusionsChildren with cleft lip and/or palate may exhibit mild OSA symptoms, including snoring and noisy breathing. Routine clinical screening remains essential to detect early signs of airway obstruction. While polysomnography is the diagnostic gold standard, further research is needed to clarify its correlation with clinical findings in this patient population.
Comprehensive Smile Component Analysis in Unilateral Cleft Lip and Palate Using Akhter-Anne Framework.
Sera Noel AT, Umar D, Koya S … +1 more , Husain A
Cleft Palate Craniofac J · 2026 Feb · PMID 41739550 · Publisher ↗
ObjectiveThis study aimed to comprehensively compare smile aesthetics between surgically corrected unilateral cleft lip and palate (CUCLP) patients and non-cleft controls, evaluating multiple facial domains to identify p...
ObjectiveThis study aimed to comprehensively compare smile aesthetics between surgically corrected unilateral cleft lip and palate (CUCLP) patients and non-cleft controls, evaluating multiple facial domains to identify persistent deficits.DesignA cross-sectional, comparative study was conducted.SettingThe study was performed in a clinical research setting.Patients/ParticipantsThe cohort consisted of 30 CUCLP patients who had undergone surgical repair and 30 age- and sex-matched non-cleft controls, all aged between 16 and 30 years.InterventionsThe intervention for the patient group was prior surgical correction of CUCLP; no new intervention was administered as part of this observational study.Main Outcome Measure(s)Standardized frontal photographs were analyzed using MAKHTER software and the Akhter-Anne Smile Diagram. Key parameters measured across facial, nasal, labial, nasolabial, and dento-gingival domains included nasal width, commissure width, philtrum height, lip length, and incisor display.ResultsThe facial component showed no significant differences. However, CUCLP patients exhibited significant deficits in other domains: reduced philtrum height (0.58 ± 0.21 mm vs. 0.84 ± 0.31 mm; p = 0.004), shorter upper lip length (0.42 ± 0.14 mm vs. 0.62 ± 0.22 mm; p = 0.001), and narrower commissure width (4.23 ± 0.52 mm vs. 6.95 ± 0.90 mm; p < 0.001). Nasal width was reduced (3.25 ± 0.40 mm vs. 4.56 ± 0.54 mm; p < 0.001) with pronounced nasolabial asymmetry. Dento-gingivally, maxillary incisor show was less (1.80 ± 0.54 mm vs. 3.45 ± 0.63 mm; p < 0.01) while mandibular incisor display was greater (2.75 ± 0.48 mm vs. 1.25 ± 0.36 mm; p < 0.05).ConclusionsDespite surgical repair, CUCLP patients have persistent esthetic impairments, particularly in the nasolabial and dento-gingival regions. A structured, multi-domain smile analysis is crucial for guiding multidisciplinary treatment to optimize final aesthetic and psychosocial outcomes.
Cephalometric Comparison of Le Fort I Osteotomy in Growing and Non-Growing Patients With Clefts: A Retrospective Study.
Merta M, Harjunpää R, Leikola J … +3 more , Suojanen J, Holmberg N, Heliövaara A
Cleft Palate Craniofac J · 2026 Feb · PMID 41739549 · Publisher ↗
ObjectiveTo cephalometrically compare craniofacial morphology and maxillary advancement in growing versus non-growing patients with clefts undergoing Le Fort I osteotomy.DesignRetrospective cohort study.SettingAll patien...
ObjectiveTo cephalometrically compare craniofacial morphology and maxillary advancement in growing versus non-growing patients with clefts undergoing Le Fort I osteotomy.DesignRetrospective cohort study.SettingAll patients underwent maxillary osteotomy at a single tertiary hospital.PatientsThe Pre-Growth-Completion group (PreGC) comprised 28 growing patients (18 males, 10 females; 9 BCLP, 18 UCLP, 1 CP) with a mean age at surgery of 13.5 years (SD = 1.22; range, 11.5-16.7). The Post-Growth-Completion group (PostGC) comprised 59 patients (28 males, 31 females; 15 BCLP, 23 UCLP, 21 CP) with a mean age at surgery of 18.3 years (SD = 4.38; range, 14.5-45.3). Patients with syndromes and those undergoing bimaxillary osteotomies were excluded.InterventionsEach patient underwent Le Fort I osteotomy. Osteotomies were fixed with patient-specific implants or miniplates.Main Outcome MeasuresCephalometric analysis was performed comparing preoperative lateral cephalometric radiographs or CT scans and immediate postoperative lateral cephalometric radiographs.ResultsPatients in PreGC group had more severe preoperative maxillary hypoplasia (SNA 74.2° vs 77.0°, = .007; ANB -5.2° vs -1.9°, = .0001), but no significant differences were observed postoperatively (SNA 80.7° vs 78.9°, ANB 2.7° vs 3.9°). Maxillary horizontal advancement was greater in the PreGC group (point A 6.4 mm vs 3.2 mm; = .00002).ConclusionsPatients undergoing early Le Fort I osteotomy had more severe preoperative maxillary hypoplasia, required greater horizontal advancements, yet achieved significant corrections comparable to patients treated later. However, early osteotomy in growing patients may be considered a 2-stage approach as secondary correction is often required after growth is complete.
Disparities in Cleft Care for Hispanic/Latino Patients in the United States: A Systematic Review and Meta-Analysis.
Nguyen AT, Li RA, Galiano RD … +1 more , Gosain AK
Cleft Palate Craniofac J · 2026 Feb · PMID 41739544 · Publisher ↗
ObjectiveTo systematically evaluate disparities in access, timing, and outcomes of cleft care for Hispanic/Latino patients in the United States.DesignSystematic review and random-effects meta-analysis conducted per PRISM...
ObjectiveTo systematically evaluate disparities in access, timing, and outcomes of cleft care for Hispanic/Latino patients in the United States.DesignSystematic review and random-effects meta-analysis conducted per PRISMA guidelines (PROSPERO CRD420251053224).SettingUS-based studies using national databases, state registries, and institutional cohorts.Patients, ParticipantsHispanic/Latino children with cleft lip and/or palate compared to non-Hispanic White children.InterventionsPrimary cleft lip and palate repair and secondary cleft-related procedures, including alveolar bone grafting.Main Outcome Measure(s)Timing of surgical interventions, postoperative complications, mortality, hospital charges, secondary procedure utilization, and patient-reported outcomes.ResultsTwenty-eight studies encompassing 30,006 Hispanic/Latino patients met inclusion criteria. Eight studies addressed surgical timing: Hispanic/Latino patients had significantly delayed primary repairs (eg, adjusted hazard ratio [aHR] 0.90 for cleft lip repair; odds ratio [OR] 2.76 for delayed palate repair) and higher rates of bone grafting after age 12 (24.4% vs. 19.4%, = .0049). Three studies reported mixed patterns of secondary procedure utilization, with underuse of some operations (OR 0.29 for higher surgery frequency) but overrepresentation in cleft rhinoplasty (OR 1.36). Two national datasets showed elevated cleft-related mortality (OR 1.54; HR 1.3-1.7). While postoperative complication rates were largely equivalent, Hispanic/Latino patients experienced longer hospital stays and higher charges in several analyses. Meta-analysis of 2 studies on delayed surgery yielded a pooled OR of 2.11 (95% confidence interval 0.23-19.80) with low heterogeneity but wide uncertainty.ConclusionsHispanic/Latino patients face multifaceted disparities in cleft care-particularly delayed surgery and fragmented follow up-despite comparable technical outcomes. Targeted interventions addressing structural, linguistic, and cultural barriers are needed to advance equity in cleft treatment.
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