Cleft Palate Craniofac. J. [JOURNAL]
Sun
200 papers
Effects of Rapid Maxillary Expansion on Upper Airway Parameters in Children With Unilateral Cleft Lip and Palate: A Cone-Beam Computed Tomography (CBCT) Study.
Alforaidi SA
Cleft Palate Craniofac J · 2026 Feb · PMID 41649946 · Publisher ↗
ObjectivesTo evaluate the effect of rapid maxillary expansion (RME) on nasopharyngeal dimensions in children with unilateral cleft lip and palate (UCLP).DesignA prospective case-series longitudinal study.SettingOrthodont...
ObjectivesTo evaluate the effect of rapid maxillary expansion (RME) on nasopharyngeal dimensions in children with unilateral cleft lip and palate (UCLP).DesignA prospective case-series longitudinal study.SettingOrthodontic Department, School of Dental Sciences.ParticipantsForty-eight children (30 males and 18 females) aged 8 to 10 years old with UCLP who had maxillary transverse constriction and need maxillary expansion.InterventionRME followed by retention phase.Main outcomeChanges in 3-dimensional nasopharyngeal parameters after RME using cephalometric radiographs and cone-beam computed tomography (CBCT).ResultsThe CBCT analysis revealed that the nasal cavity increased by 1907 mm ( < .001), the nasopharynx (NP) increased by 707 mm ( = .027), the minimum cross-sectional area increased by 29.98 mm ( < .001), and the distance between the right and left maxillary sinuses increased by 7.98 mm ( < .001), although the change in the sinus volume was insignificant ( > .05). Cephalometric measurements revealed a statistically significant inferior dislocation of the maxilla after treatment (S-S1, = .024; N-ANS, = .017), increase in the inferior anterior and posterior facial height (S-Go, = .017; ANS-Me, = .041; N-Me, = .020).ConclusionRME treatment increased some nasopharyngeal dimensions in children with UCLP and maxillary constriction.
Understanding Appearance Concerns in Young People With Cleft Lip ± Palate: A Photo Elicitation Study.
Davies J, Owen A, Burton A
Cleft Palate Craniofac J · 2026 Feb · PMID 41637381 · Publisher ↗
ObjectiveYoung people (YP) with a cleft lip with or without cleft palate have expressed concerns about their appearance and image-sharing on social media. This study aimed to explore and understand YP's concerns, views,...
ObjectiveYoung people (YP) with a cleft lip with or without cleft palate have expressed concerns about their appearance and image-sharing on social media. This study aimed to explore and understand YP's concerns, views, and experiences regarding photographs of themselves.DesignThis was an exploratory qualitative study using photo-elicitation during semi-structured interviews conducted virtually. YP provided 3 photographs of themselves they liked and 3 they did not, which were used to facilitate discussion of their appearance, thoughts, and feelings about their photographs, and social media. Interviews were transcribed and analyzed using Reflexive Thematic Analysis.Patients/ParticipantsThirteen YP aged 16 to 20 years (mean = 17.8), 10 females and 3 males, were recruited via a UK cleft charity. Two had a cleft lip only, 9 had a unilateral cleft lip and palate, and 2 had a bilateral cleft lip and palate.ResultsFour themes were developed: (1) symmetry equals beauty, (2) controlling and curating the image presented to others, (3) acceptance with maturity, and (4) connections can promote empowerment.ConclusionsThe themes highlight the concerns that YP have with their appearance, how they present their self-image to others, and how they can become empowered to embrace their cleft condition and support others. Results suggest cleft services should integrate psychosocial screening, peer support, and appearance-focused interventions to promote confidence and resilience in young people.
Predictive Capabilities of the Asher-McDade Esthetic Index for Nasolabial Revision Surgery: A Pilot Study.
Tatiyanupanwong F, Boonpratham S, Srimaneekarn N … +3 more , Chaweewannakorn C, Satravaha Y, Peanchitlertkajorn S
Cleft Palate Craniofac J · 2026 Feb · PMID 41636211 · Publisher ↗
ObjectiveThis pilot study explored the predictive capabilities of individual components and composite scores of the Asher-McDade Esthetic Index (AMEI) for determining the need for nasolabial revision surgery in patients...
ObjectiveThis pilot study explored the predictive capabilities of individual components and composite scores of the Asher-McDade Esthetic Index (AMEI) for determining the need for nasolabial revision surgery in patients with repaired complete unilateral cleft lip and palate (UCLP). Receiver operating characteristic (ROC) analysis and Youden's index were employed to assess predictive power and identify optimal thresholds, respectively.DesignSingle-center retrospective cross-sectional pilot studySettingCleft and craniofacial centerParticipantsThirty-two pre-adolescent patients with complete UCLP who underwent primary repair.InterventionsStandardized frontal and lateral facial photographs were rated by three calibrated plastic surgeons using the AMEI. Components assessed included nasal form, nasal symmetry, vermilion border, and nasolabial profile. A separate panel of three plastic surgeons determined the need for nose and/or lip surgical revision by majority vote, based on the same photographs. ROC analysis evaluated the predictive ability of individual AMEI components and composite scores, with cutoffs identified via Youden's Index.Main Outcome MeasuresThe predictive ability of AMEI for determining the need for nasolabial revision, using ROC analysis and Youden's Index.ResultsNasal symmetry demonstrated the highest predictive accuracy for nose revision, and vermilion border was the strongest predictor for lip revision. Although composite scores showed promising predictive potential, they did not surpass the predictive power of the strongest individual AMEI components.ConclusionThis pilot study provides preliminary evidence that the AMEI can serve as a useful objective tool to predict the need for revision surgery in patients with repaired UCLP.
Incidence of Ocular Abnormalities in Metopic Craniosynostosis: Cranial Vault Reconstruction Versus Endoscopic Suturectomy.
Ha JY, Doh S, Tomei KL … +2 more , Orge FH, Wang HD
Cleft Palate Craniofac J · 2026 Feb · PMID 41632637 · Publisher ↗
ObjectiveTo compare the incidence of ocular abnormalities in patients with metopic craniosynostosis (MCS) treated with cranial vault reconstruction (CVR) versus endoscopic suturectomy (ESC).DesignRetrospective cohort stu...
ObjectiveTo compare the incidence of ocular abnormalities in patients with metopic craniosynostosis (MCS) treated with cranial vault reconstruction (CVR) versus endoscopic suturectomy (ESC).DesignRetrospective cohort study using the TriNetX Research Network.SettingMulti-institutional electronic health record database.Patients, ParticipantsA total of 588 pediatric patients with non-syndromic MCS (441 CVR, 147 ESC) were identified by ICD-10 and CPT codes. Propensity score matching and age adjustment were performed to reduce confounding.InterventionsSubjects underwent either CVR or ESC. Ocular and surgical complication outcomes were assessed.Main Outcome Measure(s)Primary outcome is ocular abnormalities. Secondary outcomes include surgical complications and reoperations.ResultsOcular abnormalities were present in 40.31% of MCS patients. CVR was associated with a significantly higher incidence compared to ESC (44.67% vs 27.21%; RR = 1.64; 95% CI: 1.23-2.18). CVR patients had greater rates of strabismus (15.19% vs 7.48%; RR = 2.03; 95% CI: 1.10-3.74), ametropia (29.71% vs 11.56%; RR = 2.57; 95% CI: 1.58-4.20), and astigmatism (15.87% vs 2.72%; RR = 5.84; 95% CI: 2.17-15.70). These differences remained significant after adjusting for age and matching by sex, race, and ethnicity. The ESC group showed ocular outcomes comparable to the general pediatric population.ConclusionsPatients with metopic craniosynostosis have a high rate of ocular abnormalities, and there may be a difference between those who undergo CVR versus ESC. These findings underscore the need for routine ophthalmologic surveillance and future prospective studies are needed to confirm the findings.
Evaluation of Orbitomalar Region Projection İn Patients With Operated Cleft Lip and Palate Part 2: Effect of Maxillary Position.
Tosun G, Özdemir A, Gülşen A … +3 more , Doruk M, Şibar S, Üçüncü N
Cleft Palate Craniofac J · 2026 Jan · PMID 41604344 · Publisher ↗
ObjectiveTo evaluate the impact of maxillary position on orbitomalar and suborbital projection by comparing patients with and without cleft with normal and retrusive maxilla, and to determine whether projection loss is p...
ObjectiveTo evaluate the impact of maxillary position on orbitomalar and suborbital projection by comparing patients with and without cleft with normal and retrusive maxilla, and to determine whether projection loss is primarily related to cleft pathology or maxillary retrusion.DesignRetrospective comparative cephalometric study.SettingSingle tertiary orthodontic center; records from 2010 to 2015.PatientsA total of 142 patients (74 with cleft, 68 without cleft) aged 7 to 13 years, meeting defined inclusion criteria. Patients were divided into 4 groups according to cleft status and maxillary AP position determined by SNA: retrusive maxilla with cleft (RCMx, = 44), normal maxilla with cleft (NCMx, = 30), retrusive maxilla without cleft (RMx, = 28), and normal maxilla without cleft (NMx, = 40).InterventionsNo intervention was performed.Main Outcome MeasuresLinear orbitomalar projection measurements (LOr-VP, IOr-VP, AOr-VP, SbOr1-VP, SbOr2-VP) and maxillary position parameters (SNA, ANS-VP, A-VP). Group comparisons and correlation analyses were performed using non-parametric statistics.ResultsSignificant intergroup differences were observed for all orbitomalar and suborbital projection measurements ( < .05). Patients with retrusive maxilla, regardless of cleft status, demonstrated lower orbital and suborbital projection values compared with those with normal maxillary position. Suborbital parameters showed the largest variation between groups. Moderate-to-strong positive correlations were found between maxillary anterior development (SNA, ANS-VP, A-VP) and orbitomalar projection.ConclusionMaxillary retrusion, rather than cleft status, appears to be a key determinant of reduced orbitomalar projection and midfacial convexity. In patients with retrusive maxilla, correction of midfacial deficiency may require consideration of infraorbital and zygomatic support in addition to maxillary advancement.
Weight Gain in Infants With Pierre Robin Sequence: A Comparison of Nonsurgical Orthodontic Airway Plate Versus Surgical Mandibular Distraction Osteogenesis.
Wu RT, Grande P, Park JY … +6 more , Yamada NK, Zhang J, Lorenz HP, Menard R, Forrest CR, Choo H
Cleft Palate Craniofac J · 2026 Jan · PMID 41564262 · Publisher ↗
ObjectiveTo compare weight gain in infants with PRS treated with nonsurgical orthodontic airway plate (OAP) or surgical mandibular distraction osteogenesis (MDO).DesignRetrospective cohort study.SettingSingle tertiary-ca...
ObjectiveTo compare weight gain in infants with PRS treated with nonsurgical orthodontic airway plate (OAP) or surgical mandibular distraction osteogenesis (MDO).DesignRetrospective cohort study.SettingSingle tertiary-care pediatric center.PatientsNeonates and infants with PRS at a single institution from 2016 to 2023.InterventionsNonsurgical OAP or surgical MDO, with or without gastrostomy tube (GT) placement.Main Outcome MeasuresWeight, weight-for-age (WFA) percentile, and WFA Z-score were analyzed at four timepoints: at birth (T0), start of treatment (T1), end of treatment (T2), and end of observation (T3, approximately 12 months of age). Fisher's exact, two-tailed paired -test, and mixed effect models were used to compare groups.ResultsTwenty OAP-treated and sixteen MDO-treated infants with two MDO-Subgroups based on oral feeds status at T3. There were no differences in comorbidities between groups. GT was inserted in no infants in OAP and nine infants in MDO. The hospital stay and total treatment duration were 13.1 days (± 4.8) and 4.3 months (± 0.98) in OAP and 20.8 days (± 11.2) and 4.6 months (± 0.99) in MDO, respectively. There was no difference in weight parameters between OAP and MDO at any time point. All infants in OAP achieved full oral feeds significantly earlier than MDO (001).ConclusionsWeight gain in infants with PRS treated with either OAP alone or MDO ± GT at a single institution was similar during the first year of life.
Factor Affecting the Receiving Repeated Ventilation Tube Insertion in Children With Cleft Palate.
Malaikritsanachalee T, Vathanophas V, Chaisrisawadisuk S … +3 more , Ungkanont K, Tanphaichitr A, Wannarong T
Cleft Palate Craniofac J · 2026 Jan · PMID 41564254 · Publisher ↗
ObjectiveTo identify factors associated with repeated ventilation tube insertion (VTI) in children with cleft palate (CP) who developed otitis media with effusion (OME) before 6 years of age, and to construct a practical...
ObjectiveTo identify factors associated with repeated ventilation tube insertion (VTI) in children with cleft palate (CP) who developed otitis media with effusion (OME) before 6 years of age, and to construct a practical risk prediction scoring system.DesignRetrospective cohort study.SettingTertiary care academic hospital.ParticipantsMedical records of 127 children with CP who underwent both myringotomy with VTI and palatoplasty between 2007 and 2023 were reviewed. Patients were classified into single VTI ( = 55) and repeated VTI ( = 72) groups.InterventionsAll participants received myringotomy with VTI as standard OME management. Palatoplasty techniques included intravelar veloplasty and double-opposing Z-plasty, with or without hamulus fracture.Outcome MeasuresTen potential risk factors were evaluated, including craniofacial syndromes, premyringotomy hearing level, acute otitis media history, cleft type and gap width, middle ear fluid type, tympanic membrane (TM) retraction, surgeon level, palatoplasty technique, and hamulus fracture. Logistic regression was used to develop a predictive scoring system.ResultsMultivariate analysis identified thick middle ear fluid (odds ratio (OR) 3.18, = .008), TM retraction (OR 4.06, = .043), and premyringotomy hearing level >40 dB (OR 3.50, = .010) as independent predictors of repeat VTI. A 0 to 4 point scoring system showed acceptable discrimination (area under the curve = 0.732).ConclusionChildren with TM retraction, thick middle ear fluid, or hearing loss >40 dB are at higher risk for repeated VTI. This scoring system supports early identification, caregiver counseling, and closer follow-up to optimize middle ear outcomes.
Tissue Adhesive Versus Sutures for Skin Closure in Primary Cleft Lip Repair: A Systematic Review and Meta-Analysis.
Jain A, Chandak A, Yadav A
Cleft Palate Craniofac J · 2026 Jan · PMID 41564253 · Publisher ↗
To evaluate the effectiveness of cyanoacrylate tissue adhesives versus conventional sutures for skin closure in primary cleft lip repair, focusing on esthetic, clinical, and patient-centered outcomes.Systematic review an...
To evaluate the effectiveness of cyanoacrylate tissue adhesives versus conventional sutures for skin closure in primary cleft lip repair, focusing on esthetic, clinical, and patient-centered outcomes.Systematic review and meta-analysis of randomized controlled trials and comparative observational studies.Multicenter data synthesis including studies from the United States, the United Kingdom, India, Nigeria, and the Netherlands.A total of 442 patients undergoing primary cleft lip repair, with 402 contributing extractable outcome data.Epidermal closure using tissue adhesives (octyl-2-cyanoacrylate, iso-amyl cyanoacrylate, or octyl-2-cyanoacrylate with polyester mesh tape) compared with fine nonabsorbable sutures (nylon, Prolene, or Monocryl).Esthetic scar quality, wound complications, parental satisfaction, operative time, and scar-related secondary parameters (eg, white roll alignment, hypertrophic scarring).Eight studies met inclusion criteria, of which 2 were randomized controlled trials. Meta-analysis showed no significant difference in esthetic outcomes between adhesives and sutures (SMD -0.05, 95 % confidence interval [95% CI] [-0.28 to 0.18]; I = 12%). Complication rates were comparable (RR 0.93, 95% CI [0.41-2.11]). Operative time was consistently shorter with adhesives, reducing closure by 5 to 7 min per case. Parental satisfaction was uniformly higher in adhesive groups. Evidence certainty was graded moderate for esthetic outcomes and wound complications, and low for operative time and satisfaction.Tissue adhesives provide equivalent esthetic and complication outcomes to sutures in cleft lip repair, with added advantages of faster closure and improved parental satisfaction. Incorporating adhesives into cleft protocols may enhance efficiency and patient-centered care, though further high-quality trials with long-term follow-up are warranted.
Standardized Method for Description of Cleft Lip and Palate Phenotypes and Its Implementation in Daily Practice: Validation Study.
Vlahovic A, Stefanovic O, Mladenovic K … +10 more , Mijovic T, Vasic M, Milickovic M, Rasic P, Djordjevic N, Sindjic-Antunovic S, Ducic S, Dasic I, Zdujic N, Nikolic D
Cleft Palate Craniofac J · 2026 Jan · PMID 41564251 · Publisher ↗
BackgroundCleft lip and palate are the most common congenital craniofacial anomalies. There are several classifications of cleft lip and palate that have been proposed over the years; however, only a few have found clini...
BackgroundCleft lip and palate are the most common congenital craniofacial anomalies. There are several classifications of cleft lip and palate that have been proposed over the years; however, only a few have found clinical application. We presented classification of a cleft lip and palate that is comprehensive and uniform, and it can precisely define the vast majority of the clefts.MethodsFive hundred and twenty-one consecutive patients underwent their primary surgical procedure for cleft lip and palate deformities. These intraoperative diagnoses were translated into abbreviated diagnoses based on the classification that we presented. In this paper, we compared the accuracy of preoperative diagnoses with that of intraoperative diagnoses according to the well-known classification of cleft lip and palate that we presented.ResultsA total of 343 cleft lip surgeries and 413 palatoplasty surgeries were performed on 521 patients. The isolated cleft palate was the most common type of cleft in our group of patients. Associated anomalies occurred in 16% of patients with clefts of the lip and palate. In our study, 18% of patients had an inaccurate preoperative diagnosis. The intraoperative diagnoses were more accurate compared to preoperative diagnoses. The simplicity and comprehensibility of the proposed classification were shown through the comparison of preoperative, intraoperative, and diagnostic information presented by this classification.ConclusionThe classification of cleft lip and palate that we presented is clear, easy to understand, and can be a successful tool in studying the epidemiology of clefts.
Dutch and Belgian Workflow for Ventilation Tubes Insertion in Children With Cleft Palate-A Survey Study.
Sofia B, Wouter L, Rienk HD … +4 more , Astrid KM, Henrietta G, Corstiaan B, Chantal MV
Cleft Palate Craniofac J · 2026 Jan · PMID 41564250 · Publisher ↗
ObjectiveThe goal of this study is to provide an overview of the current clinical practices of cleft teams affiliated to the Dutch Association for Cleft Palate (CP) and Craniofacial anomalies in the Netherlands and in Be...
ObjectiveThe goal of this study is to provide an overview of the current clinical practices of cleft teams affiliated to the Dutch Association for Cleft Palate (CP) and Craniofacial anomalies in the Netherlands and in Belgium, with regards to the placement of ventilation tubes in young children with CP.DesignCross-sectional survey.SettingMulticenter study, Oral Cleft Referral Centers of the Netherlands and Belgium.Patients, ParticipantsEar-nose-throat (ENT) surgeons, plastic surgeons, and language speech pathologists.InterventionsOnline survey.Main Outcome Measure(s)The survey questions covered the following topics: audiology assessment before palatoplasty, ventilation tube insertion (VTI) timing, postoperative follow-up visits.ResultsResponse rate per center was 100% (11/11 cleft centers), for a total of 21 cleft specialists (44%). Most centers ( = 7/11) establish VTI indication before palatoplasty by means of audiology assessment combined with ENT surgeon examination. Most centers combine VTI with palatoplasty ( = 9/11), and schedule a routine follow-up 2 to 3 months after surgery ( = 7/11).ConclusionsAlthough no standardized national or international protocols exist for the diagnosis and treatment of otitis media with effusion in children with CP, most Dutch and both Belgian cleft centers have independently developed local protocols that are largely aligned. Formalizing these into a unified written protocol represents an important next step toward optimizing and standardizing care for this patient population.
A Comparative Study on Vertical and Transverse Orthodontic Relapse in Patients with and Without Cleft Lip and Palate.
Paul NJ, Kannan A, Kailasam V
Cleft Palate Craniofac J · 2026 Jan · PMID 41564248 · Publisher ↗
ObjectiveTo compare the 2-year post-treatment stability of vertical and transverse dimensions in orthodontic patients with non-syndromic cleft lip and palate (CLP) versus non-cleft controls (NC).DesignRetrospective compa...
ObjectiveTo compare the 2-year post-treatment stability of vertical and transverse dimensions in orthodontic patients with non-syndromic cleft lip and palate (CLP) versus non-cleft controls (NC).DesignRetrospective comparative study.Patients/ParticipantsTwenty-eight patients divided into CLP ( = 14) and NC ( = 14) groups matched for age and sex.InterventionsOrthodontic fixed appliance therapy followed by removable vacuum-formed retainers.Main Outcome MeasuresVertical changes were assessed with lateral cephalograms, and transverse relationships were analyzed using the Modified Huddart-Bodenham (MHB) Index. Intragroup changes (T0-T1) were analyzed with paired -tests and intergroup differences with unpaired -tests ( < .05).ResultsAt 2-year post-treatment, the cleft group showed significant reductions in anterior facial height (-1.06 ± 0.59 mm, < .001), U1-NF (-0.31 ± 0.48 mm, = .01), L1-MP (-0.54 ± 0.63 mm, = .004), and U6-NF (-0.66 ± 0.70 mm, < .001). Transverse relapse was evident at the incisors (-0.36 ± 0.50, = .006), molars (-0.43 ± 0.51, = .002), and in total scores (-0.29 ± 0.47, = .007). The NC group showed minimal changes ( > .05).ConclusionsPatients with CLP demonstrate greater vertical and transverse orthodontic relapse 2-year post-treatment compared to non-cleft patients. These findings underscore the necessity for potential permanent retention protocols tailored to the unique anatomical and physiological challenges of the cleft population.
Food Security Impacts Health of Children With Orofacial Clefts: An 8-Year Review of the Global Burden of Disease Study.
Tiongco RFP, Malek AJ, Ali A … +5 more , He H, Yu JC, Lavie JL, King BJ, Masoumy M
Cleft Palate Craniofac J · 2026 Mar · PMID 41553829 · Full text
ObjectiveTo determine if increased food security (FS) reduces mortality, prevalence, and disability in patients with orofacial clefts (OFCs).DesignEcological study.SettingA total of 204 countries and territories in the G...
ObjectiveTo determine if increased food security (FS) reduces mortality, prevalence, and disability in patients with orofacial clefts (OFCs).DesignEcological study.SettingA total of 204 countries and territories in the Global Burden of Disease Study and FS data from 113 countries from the Global Food Security Index.Patients, ParticipantsDeidentified country-level data on patients with OFCs <4 years old from years 2012 to 2019.InterventionsNone.Main Outcome MeasureNumber of deaths from OFCs, prevalence of OFCs, and disability adjusted life years (DALYs) from OFCs per 100,000 people.ResultsOf 113 countries with data from 2012 to 2019, regression showed a 13.8% decreased rate of death (incidence rate ratio 0.862 [95% confidence interval (CI) 0.852, 0.871]) and 74.9% higher odds of nondeath (odds ratio 1.749 [95% CI 1.106, 2.786]) with a 1-point increase in FS score. A linear relationship was demonstrated between FS and prevalence of OFCs (β -18.5 [95% CI -34.8, -2.3]) and DALYs from OFCs (β -43.1 [95% CI -62.6, -23.5]) with a 1-point increase in FS score as well. The greatest reductions in mortality and DALYs were seen in children <1 year whereas reductions in prevalence were seen in children 2-4 years, attributed to decreases in late presentations.ConclusionOur study shows higher FS is associated with reduced deaths from OFCs, prevalence of OFCs, and DALYs from OFCs. We hope our study validates efforts by nutritional programs led by OFC teams and provides evidence for further support.
Cleft Summit 2023: How NGOs can Promote Development of Sustainable Interdisciplinary Cleft Care.
Rodriguez T, Vyas R, Andari D … +5 more , Assaf R, Annan B, Ayala R, Hamdan U, Cleft Summit 2023 Consortium
Cleft Palate Craniofac J · 2026 Jan · PMID 41553828 · Publisher ↗
ObjectiveThe 2 Cleft Summit aimed to understand what policies and actions various cleft-centered non-governmental organizations (NGOs) can adopt to achieve sustainable, patient-centered, interdisciplinary cleft care.Desi...
ObjectiveThe 2 Cleft Summit aimed to understand what policies and actions various cleft-centered non-governmental organizations (NGOs) can adopt to achieve sustainable, patient-centered, interdisciplinary cleft care.DesignA Summit of global leaders in interdisciplinary cleft care.SettingA two-hour discussion within a three-and-a-half-day International Comprehensive Cleft Care Workshop (CCCW).ParticipantsTwenty-eight global leaders from various cleft-focused specialties.InterventionsThe Second Cleft Summit was held to collaboratively improve understanding among global cleft leaders regarding the role and responsibility of NGOs to provide sustainable interdisciplinary cleft care.Main Outcome MeasuresThe summit's primary objective was to explore and develop strategies to strengthen interdisciplinary cleft care, particularly in resource-limited settings.ResultsParticipants agreed on the need to shift NGO focus toward interdisciplinary, patient-centered care that extends beyond a single program to include long-term follow-up. They also strongly encouraged empowering on-site medical providers and teams through bidirectional education (lectures, case discussions) and capacity-building (workshops, simulation). Health system strengthening emerged as a uniformly viable pathway to ensuring sustainable care delivery while diminishing the footprint of international NGOs.ConclusionThe summit emphasized the need for systemic strengthening of the health delivery infrastructure alongside education and capacity-building. Whenever feasible, NGOs should collaborate with local governments and regional stakeholders through a bidirectional exchange of knowledge and skills.
Visualizing the Timeline of Care: Development of a Graphical Approach to Better Understanding Complex, Longitudinal Surgical Care of Cleft Lip/Palate.
Lin E, Yi VN, Dunworth K … +3 more , Cox M, Patel K, Allori AC
Cleft Palate Craniofac J · 2026 Jan · PMID 41549683 · Publisher ↗
ObjectiveDevelop and apply novel data visualization techniques to analyze longitudinal cleft surgical care and to identify patterns in treatment timing and procedural burden across 2 cleft teams.DesignRetrospective cohor...
ObjectiveDevelop and apply novel data visualization techniques to analyze longitudinal cleft surgical care and to identify patterns in treatment timing and procedural burden across 2 cleft teams.DesignRetrospective cohort study of operative data using novel data visualization methods.SettingTwo cleft teams in the United States.Patients and ParticipantsPatients with cleft lip and/or palate with operative clinical encounters between 2018 and 2023. Team A had 228 patients and team B had 355.InterventionsVisualization of primary cleft-related surgical procedures which were cleft lip and palate repair, fistula repair, alveolar bone grafting, correction of velopharyngeal insufficiency, orthognathic surgery, and rhinoplasty.Main Outcome Measure(s)Visual interpretation of surgical timing, frequency, volume, and distribution using novel timelines, stacked-bar charts, and ridgeplots.ResultsTimeline visualizations clarified procedural sequencing and highlighted variation in treatment timing by team and phenotype but were too dense for interpretation for a large volume of patients. Stacked-bar charts illustrated procedural volume but lacked temporal insight. Ridgeplots demonstrated both timing of procedures and aggregate team volume.ConclusionsIndividual patient timelines can effectively depict deviation from "ideal" care protocols, but aggregate data may be best depicted by a ridgeplot. These tools may support quality improvement initiatives by transforming raw data into actionable insights and enhancing multidisciplinary team reflection.
Examining Sociodemographic Disparities in Diagnostic Delays and Surgical Management of Non-Syndromic Craniosynostosis: A 10-Year Review.
Bakovic M, Finestone SA, Ortiz-Ocasio LS … +11 more , Goldman J, Zhang A, Sun KH, Boyarsky B, Mantilla-Rivas E, Zhang VS, O'Brien PF, Teti SA, Keating RF, Oh AK, Rogers GF
Cleft Palate Craniofac J · 2026 Jan · PMID 41512090 · Publisher ↗
ObjectiveTo investigate the impact of sociodemographic factors on the surgical management and outcomes of patients with non-syndromic craniosynostosis, with a focus on delays in diagnosis and intervention.DesignRetrospec...
ObjectiveTo investigate the impact of sociodemographic factors on the surgical management and outcomes of patients with non-syndromic craniosynostosis, with a focus on delays in diagnosis and intervention.DesignRetrospective cohort study.SettingTertiary pediatric hospital.PatientsThree hundred seventy-three non-syndromic patients who underwent primary craniosynostosis surgery between 2013 and 2023.Main Outcome MeasuresPrimary outcomes included age at first specialty appointment, age at diagnosis, age at surgery, and type of surgery (CVR, open cranial vault remodeling; or ES + HT, endoscopic suturectomy + helmet therapy). Secondary outcomes included postoperative complications, need for additional craniofacial procedures, and length of hospital stay.ResultsPatients undergoing CVR were older at the time of specialty appointments (median 6.6 vs. 1.9 months, P < 0.001), diagnosis (median 8.1 vs. 2.1 months, P < 0.001), and surgery (median 11.3 vs. 2.9 months, P < 0.001) compared to those undergoing ES + HT. When controlling procedure type and sociodemographic variables, private insurance was a predictor of earlier diagnosis (β=-3.06, 95% CI [-5.97, -0.16], P = 0.039) and earlier surgical intervention (β=-3.55, 95% CI [-6.67, -0.42], P = 0.026). Independent predictors of longer hospital stay included Hispanic ethnicity (β=0.45, 95% CI [0.03, 0.87], P = 0.035) and higher national Area Deprivation Index (ADI) score (β=0.014, 95% CI [0.008, 0.021], P < 0.001). After multivariable adjustment, complication rates and the need for additional craniofacial procedures did not differ significantly between ES + HT and CVR.ConclusionPatients with public insurance were more likely to experience a delay in diagnosis and, consequently, underwent a more invasive CVR procedure than privately insured patients. Hispanic ethnicity and higher ADI were associated with longer hospitalizations.
Predictors of Vocabulary and Morphosyntax Ability in 2-Year-Old Children with Repaired Cleft Palate.
Wilder A, Lien KM, Heimbaugh L … +3 more , Hardin-Jones M, Chapman KL, Cleft Outcomes Research NETwork (CORNET) Consortium
Cleft Palate Craniofac J · 2026 Mar · PMID 41468037 · Publisher ↗
ObjectiveTo identify morphosyntax and lexical ability predictors in children with repaired cleft palate (CP) with or without cleft lip (CP ± L).DesignProspective longitudinal cohort study.SettingMultisite institutional.P...
ObjectiveTo identify morphosyntax and lexical ability predictors in children with repaired cleft palate (CP) with or without cleft lip (CP ± L).DesignProspective longitudinal cohort study.SettingMultisite institutional.ParticipantsEighty-eight toddlers with nonsyndromic CP ± L.ProceduresParticipants' parents completed the MacArthur-Bates Communicative Development Inventories (CDI) Words and Gestures and background information questionnaires at 16-month visits. They also recorded 2 to 4 hours of their child's vocalizations/words using Language Environmental Analysis (LENA™) recorders. Recordings were analyzed for the number and type of consonants produced. At 24-month visits, parents completed the CDI Words and Sentences.Main Outcome MeasuresMean utterance length of the child's three longest utterances (M3L) and expressive vocabulary reported on the CDI Words and Sentences.ResultsThe results showed significant associations for vocabulary and M3L at 24 months with maternal education level (MEL), total consonants, stop consonants, CDI words produced, and CDI words understood at 16 months. Additionally, vocabulary and the area deprivation index were significantly correlated. Age at palatoplasty, cleft Veau classification, Pierre Robin Sequence, preterm birth, and family history of speech-language delay/disorder were not significantly associated with M3L or vocabulary. Linear regression indicated that MEL, stop consonant production, and CDI words understood at 16 months significantly predicted expressive vocabulary and M3L at 24 months.ConclusionStop consonant production remained a significant predictor of expressive vocabulary and morphosyntax skills, after controlling for other factors. These findings suggest early intervention targeting stop production should promote expressive language skills. Children's stop consonant inventory should be closely monitored following palatoplasty.
Advancing Prediction of Secondary Speech Surgery After Palatoplasty.
Chen J
Cleft Palate Craniofac J · 2025 Dec · PMID 41468006 · Publisher ↗
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Successful Premaxillary Reconstruction and Oronasal Fistula Closure in a Patient With VATER Syndrome With Bilateral Cleft and Missing Premaxilla.
Workman J, Atte A, Wong P … +1 more , Ritto F
Cleft Palate Craniofac J · 2025 Dec · PMID 41460690 · Publisher ↗
VATER syndrome is a non-random association of birth defects affecting multiple organ systems, with orofacial clefts uncommonly reported. This study presents a unique case of a patient with VATER syndrome with a bilateral...
VATER syndrome is a non-random association of birth defects affecting multiple organ systems, with orofacial clefts uncommonly reported. This study presents a unique case of a patient with VATER syndrome with a bilateral cleft lip and palate who underwent the rare surgical removal of the premaxilla during cleft lip repair, resulting in a large maxillary defect and oronasal fistula. This report highlights the successful use of non-vascularized bone graft in this setting, with 13-month follow-up demonstrating bone consolidation and fistula closure. The case adds to the evidence supporting non-vascularized bone graft for extensive maxillary defects, even with oronasal fistula.
Effect of Language Interpreter Modalities on Patient Satisfaction and Clinical Workflow: A Pilot Study in a Multidisciplinary Pediatric Craniofacial Clinic.
Juang S, Nguyen S, Osman N … +14 more , Ghodrati K, Reyes C, Maldonado I, Pino J, Duarte M, Halley K, Hendrickson I, Tu M, Peralta JB, Wilhalme H, Kosack A, Lloyd J, Lerner C, Thang CK
Cleft Palate Craniofac J · 2026 Mar · PMID 41460683 · Full text
ObjectiveTo evaluate the feasibility and impact of remote consecutive, in-person consecutive, and in-person simultaneous interpreter modalities on clinical workflow, patient experience, and provider experience in a multi...
ObjectiveTo evaluate the feasibility and impact of remote consecutive, in-person consecutive, and in-person simultaneous interpreter modalities on clinical workflow, patient experience, and provider experience in a multidisciplinary pediatric craniofacial clinic.DesignMixed-methods study incorporating quantitative clinical workflow and patient survey data with qualitative semi-structured interviews.SettingSingle-site multidisciplinary pediatric craniofacial clinic at an academic medical center.Patients, ParticipantsA total of 170 patients were seen during the study period: 126 (74.1%) English-speaking (for no interpreter comparison) and 44 (25.9%) Spanish-speaking using interpreter services. A total of 105 (61.8%) patients completed voluntary patient satisfaction surveys. Sixteen craniofacial providers and four Spanish-speaking interpreters participated in interviews.InterventionsLanguage interpretation was provided via three modalities: remote (audio and video) consecutive, in-person consecutive, and in-person simultaneous.Main Outcome Measure(s)Clinic cycle time and face-to-face time; patient satisfaction scores; thematic analysis of provider and interpreter interviews.ResultsClinic time and satisfaction scores did not differ significantly across modalities. Interviews revealed that in-person interpretation supported rapport, trust, and clarity, while remote interpretation posed technical and relational challenges. Simultaneous interpretation was valued for efficiency but required greater cognitive effort from interpreters. Preferences for in-person consecutive and simultaneous interpretation varied with patient and clinic needs.ConclusionsWhile quantitative outcomes showed minimal workflow differences among interpreter modalities, qualitative findings highlight important communication benefits of in-person interpretation, especially when interpreters are experienced and integrated into the care team. Tailored interpretation approaches may better promote equitable care in multidisciplinary pediatric craniofacial settings.
Surgical Outcomes of Submucous Cleft Palate Using Intravelar Veloplasty with a Buccinator Musculomucosal Flap: A Case Series.
Yaguchi K, Noguchi M, Nagai F … +4 more , Hoshino Y, Akimoto M, Tsunekawa K, Yuzuriha S
Cleft Palate Craniofac J · 2025 Dec · PMID 41460679 · Publisher ↗
ObjectiveInvestigate the pre- and postoperative changes in patients with submucous cleft palate (SMCP) treated by intravelar veloplasty (IVV) with a buccinator musculomucosal flap (BMMF).DesignRetrospective case series.S...
ObjectiveInvestigate the pre- and postoperative changes in patients with submucous cleft palate (SMCP) treated by intravelar veloplasty (IVV) with a buccinator musculomucosal flap (BMMF).DesignRetrospective case series.SettingTertiary, cleft team.Patients/ParticipantsChildren with SMCP who underwent IVV with a BMMF at Nagano Children's Hospital. IVV with a BMMF between December 2018 and January 2022.Main outcome measuresPerceptual Japanese speech evaluation (hypernasality [HN], nasal emission, and intelligibility [IN]), amount of velopharyngeal (VP) gap, degree of soft palate elevation, amount of soft palate lengthening, VP closure pattern, additional surgery, and postoperative complications.ResultsEleven patients (four syndromic) were analyzed pre- and almost of 1 year postoperatively. Preoperative mean HN and IN scores were significantly improved ( = .0232 and = .0313, respectively). VP gap was closed after surgery in most cases with initial VP gap <4.5 mm and good soft palate elevation. Mean soft palate lengthening with the BMMF method was 3.9 ± 1.2 mm, which was a significant increase ( = .00589). Four patients required additional surgery. We encountered no severe postoperative complications or fistula formation.ConclusionsIVV with a BMMF is considered applicable in patients with VP gap of up to 4.0 to 4.5 mm and good soft palate elevation. Our technique appears safe, with low risks of severe postoperative complications and fistula formation. Due to the limited cohort size, more cases are needed to elucidate the precise indications for the BMMF method.
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