Cleft Palate Craniofac. J. [JOURNAL]
Sun
200 papers
Life-Course Patterns of Medical and Dental Care in Patients with Cleft Lip and/or Palate: A Nationwide Claims-Based Study.
Kuwajima Y, Ueda A, Tanaka H … +3 more , Honda T, Ishikawa-Nagai S, Satoh K
Cleft Palate Craniofac J · 2026 Jul · PMID 42396868 · Publisher ↗
ObjectiveTo characterize diagnosis-specific structures and temporal trajectories of medical and dental healthcare utilization for cleft-related conditions using a nationwide claims database in Japan.DesignNationwide retr...
ObjectiveTo characterize diagnosis-specific structures and temporal trajectories of medical and dental healthcare utilization for cleft-related conditions using a nationwide claims database in Japan.DesignNationwide retrospective cross-sectional observational study.SettingAnalysis of Japan's National Database of Health Insurance Claims and Specific Health Checkups for 2019.Patients, ParticipantsWe analyzed 52,326 patients with cleft palate (CP), cleft lip and palate (CLAP), cleft lip and alveolus (CLA), and cleft lip (CL) who generated insurance claims during the study period.InterventionsNone.Main Outcome Measure(s)We compared distributions of medical and dental visits by diagnosis and calculated diagnosis-specific dental-to-medical visit ratios. Differences were assessed using chi-square tests with effect size estimated by Cramér's V. Temporal differences in utilization were evaluated by calculating weighted mean age based on age group-specific visits for medical and dental care.ResultsA significant association was observed between diagnosis and type of care (chi-square test, < 0.001; effect size by Cramér's V). Dental visits predominated among patients with CLAP and CLA, whereas medical visits were relatively more frequent among those with CP and CL. The dental-to-medical visit ratio exceeded 1.0 in CLAP and CLA but remained below 1.0 in CP and CL. Across all diagnoses, weighted mean age for dental visits was higher than that for medical visits, indicating a shift from early medical care to sustained dental care; this shift was most pronounced in CLAP.ConclusionsDiagnosis-specific differences exist in the structure and temporal dynamics of medical and dental care among patients with cleft-related conditions.
Asymmetry of Maxillary Bone Structure in Unilateral Cleft Lip and Palate: A Cone Beam Computed Tomography Study.
Atapek MM
Cleft Palate Craniofac J · 2026 Jul · PMID 42396855 · Publisher ↗
ObjectiveTo compare maxillary bone structure between right- and left-sided unilateral cleft lip and palate (UCLP), quantify cleft vs. non-cleft asymmetry, and determine whether the non-cleft side differs from healthy con...
ObjectiveTo compare maxillary bone structure between right- and left-sided unilateral cleft lip and palate (UCLP), quantify cleft vs. non-cleft asymmetry, and determine whether the non-cleft side differs from healthy controls.DesignRetrospective cross-sectional cohort study.SettingUniversity hospital, Department of Oral and Dentomaxillofacial Radiology.Patients, ParticipantsFifty UCLP (25 right, 25 left; mean age 14.8 ± 5.1 years) and 50 controls (16.5 ± 4.6 years). Power calculation indicated n = 28/group sufficient.InterventionsCortical thickness measured on CBCT at 4-12 mm depth across 6 interradicular regions. Trabecular architecture assessed by fractal dimension (FD) (BoneJ/Fiji).Main Outcome MeasuresCortical thickness and FD differences between right-/left-UCLP, cleft vs. non-cleft sides, non-cleft vs. controls.ResultsNo differences between right- and left-UCLP cleft sides ( > 0.05). Cleft side thickness was 0.05-0.07 mm less than non-cleft side in anterior regions ( < 0.001, d = 0.30-0.38). Non-cleft side was thinner than controls by 0.12-0.18 mm ( < 0.001), representing 86-92% of control thickness. FD showed similar patterns. Asymmetry increased from posterior to anterior.ConclusionsUCLP is associated with bilateral maxillary bone deficits; the non-cleft side also shows significant deviations from controls. Side-specific assessment is essential. These differences may warrant caution in treatment planning, but prospective outcome studies are needed.
Global and Regional Perspectives on Parental Satisfaction in Cleft Lip Care: A Scoping Review.
Ali AEAO
Cleft Palate Craniofac J · 2026 Jul · PMID 42396843 · Publisher ↗
ObjectiveTo map the existing literature on parental satisfaction regarding cleft lip care, identifying global trends and regional disparities in treatment outcomes and communication protocols.DesignScoping review of lite...
ObjectiveTo map the existing literature on parental satisfaction regarding cleft lip care, identifying global trends and regional disparities in treatment outcomes and communication protocols.DesignScoping review of literature published between 2010 and 2025.SettingGlobal scoping review.InterventionsPrimary cleft lip repair.Patients/ParticipantsParents and primary caregivers of children who underwent primary cleft lip repair.Main Outcome MeasuresParental satisfaction scores related to surgical aesthetics, functional outcomes, and multidisciplinary team communication.ResultsA total of 53 studies met the inclusion criteria. Significant regional variations were observed. High-income countries reported higher satisfaction with multidisciplinary communication, whereas low- and middle-income countries highlighted surgical aesthetics as the primary driver of satisfaction, often complicated by limited access to secondary revisions.ConclusionStandardized, culturally sensitive assessment tools are required to accurately measure parental satisfaction globally. Improving preoperative communication is universally recommended to align parental expectations with achievable surgical outcomes.
Assessment of Felt Needs of Caregivers of Children With Orofacial Cleft in a Low-Middle-Income Country: A Longitudinal Study.
Adekunle AA, Egbunah UP, Adamson OO … +4 more , James O, Ogunlewe MO, Butali A, Adeyemo WL
Cleft Palate Craniofac J · 2026 Jul · PMID 42390473 · Publisher ↗
ObjectiveTo determine the changes in felt needs of caregivers of children with cleft lip and/or palate (iCL/P) from first clinic presentation to first surgical intervention.DesignLongitudinal observational study.SettingA...
ObjectiveTo determine the changes in felt needs of caregivers of children with cleft lip and/or palate (iCL/P) from first clinic presentation to first surgical intervention.DesignLongitudinal observational study.SettingA tertiary hospital in Nigeria.Patients, ParticipantsCaregivers of children with nonsyndromic CL/P (iCL/P) managed at a tertiary hospital in Nigeria from January 2023 to December 2024.InterventionMultiple semistructured counseling sessions.Main Outcome MeasuresCaregivers felt needs at time of first clinic presentation (T) and at time of first surgical intervention (T).ResultsEighty caregivers, all mothers of children with iCL/P were included. Their mean age was 31.1 ± 6.24 years. At T, information on etiology of iCL/P, surgical intervention, feeding and potential speech challenges were considered very significant needs. Feeding was also considered a primary concern for most participants. At T, after counseling sessions, there was a statistically significant reduction in the proportion of caregivers who considered information on surgical intervention, improvement in family and community acceptance and improvement in clinical psychology as very significant needs, while potential speech challenge became the primary concern of most caregivers. Caregivers of children below 1 month of age were also found to have significantly higher felt needs compared to those with older children.ConclusionsThe waiting period between birth and first corrective surgery can be stressful for caregivers of children with iCL/P. Repeated counseling from first clinic visit to first surgical intervention may be beneficial to caregivers and should focus on the domains of needs highlighted in this study.
Bridging Ergonomic Awareness and Practice in Cleft Surgery: Insights From An International Craniofacial Cleft Workshop.
Halwani A, Rodriguez T, Andari D … +4 more , Assaf R, Roggiero G, Loor Parada DA, Hamdan U
Cleft Palate Craniofac J · 2026 Jul · PMID 42390444 · Publisher ↗
ObjectiveTo determine the prevalence and anatomical distribution of work-related musculoskeletal disorders (WRMDs) among cleft surgeons and evaluate associations with ergonomic practices, training exposure, and physical...
ObjectiveTo determine the prevalence and anatomical distribution of work-related musculoskeletal disorders (WRMDs) among cleft surgeons and evaluate associations with ergonomic practices, training exposure, and physical activity patterns.DesignCross-sectional survey study.SettingAn International Craniofacial Cleft Workshop.ParticipantsCleft surgeons attending the workshop either in person or virtually.InterventionsNone. A 25-item anonymous questionnaire assessing musculoskeletal symptoms, ergonomic behaviors, and physical activity habits was administered.Main Outcome MeasuresPrevalence and anatomical distribution of self-reported musculoskeletal discomfort among participating cleft surgeons across predefined anatomical regions. Extensive musculoskeletal involvement was defined as symptoms affecting three or more anatomical regions. Associations between ergonomic behaviors, prior ergonomic training, physical activity patterns, and musculoskeletal burden were analyzed to identify potential contributing and protective factors.ResultsA total of 108 surgeons responded to the survey. Musculoskeletal discomfort was highly prevalent, most commonly affecting the neck (68.5%), lower back (38.9%), and upper back (34.3%). Many respondents reported that symptoms interfered with leisure activities, concentration, or surgical performance. Although most surgeons indicated familiarity with surgical ergonomics, only 18.5% had received formal ergonomic training. Preventive intraoperative behaviors such as posture monitoring and micro-breaks were inconsistently practiced. Strength training was independently associated with lower odds of extensive musculoskeletal involvement (Odds ratio 0.61; 95% confidence interval 0.15-0.99).ConclusionsWRMDs are common among cleft surgeons, and ergonomic awareness does not consistently translate into preventive behaviors. Incorporating structured ergonomics education into surgical training and implementing standardized intraoperative preventive strategies may promote long-term musculoskeletal health and career sustainability in cleft practice.
Patient-Specific 3D Printed Palatal Protection Plates for Le Fort III Osteotomy in Syndromic Midface Hypoplasia: What We Do.
Fuchs J, Bouffleur F, Appel M … +4 more , Zittel S, Kühle R, Hoffmann J, Engel M
Cleft Palate Craniofac J · 2026 Jul · PMID 42383896 · Publisher ↗
BackgroundSyndromic midface hypoplasia often includes a high or fragile palate that is vulnerable during midfacial disimpaction.SolutionWe created a patient-specific palatal protection plate produced through a fully digi...
BackgroundSyndromic midface hypoplasia often includes a high or fragile palate that is vulnerable during midfacial disimpaction.SolutionWe created a patient-specific palatal protection plate produced through a fully digital workflow to stabilize and protect the palate.What we didAfter using conventional plates from 2022 to 2024, we implemented a digital design and printing workflow in 2025 and added suction-catheter sleeves to the Rowe forceps branches to improve retention.
Development and Reliability Assessment of the Presurgical Infant Orthopedics Assessment Tool for Evaluating Clinical Outcomes of Presurgical Infant Orthopedics.
Figueroa A, Dominguez M, Batra P … +4 more , Mejia M, Castillo T, Pandan J, Lacerda RHW
Cleft Palate Craniofac J · 2026 Jun · PMID 42377387 · Publisher ↗
ObjectivePresurgical infant orthopedics (PSIO) is used to optimize anatomical outcomes in infants with cleft lip and palate to facilitate favorable surgical results. However, standardized, reliable tools to assess PSIO e...
ObjectivePresurgical infant orthopedics (PSIO) is used to optimize anatomical outcomes in infants with cleft lip and palate to facilitate favorable surgical results. However, standardized, reliable tools to assess PSIO effectiveness are lacking due to phenotypic variability and diverse treatment protocols. This study aimed to develop and perform a preliminary reliability assessment of a novel phenotype-based clinical outcome assessment tool, the PSIO Assessment Tool (PAT), to assess PSIO-related morphological changes in unilateral and bilateral cleft lip with or without palate.vdDesignTool Development and Reliability Assessment Study.SettingMulticentre expert consensus involving craniofacial orthodontists from diverse global regions.ParticipantsStandardized pretreatment and post-treatment clinical cases of unilateral and bilateral cleft lip and alveolus with or without palate were used for calibration and reliability assessment.InterventionA panel of 7 expert craniofacial orthodontists collaboratively developed the PAT through iterative calibration using clinical cases. The tool assesses cleft severity pretreatment and morphological correction post-treatment, grading cleft width, nasal symmetry, and alveolar alignment.Main Outcome Measure(s)Reliability was evaluated via inter-rater and intrarater agreement using Fleiss κ and quadratic weighted Cohen's κ statistics.ResultsThe PAT demonstrated good preliminary inter-rater and intrarater reliability, with inter-rater Fleiss' κ of 0.83 for pretreatment grading and weighted Cohen's κ of 0.75 for post-treatment grading. Intrarater reliability was substantial to almost perfect (κ = 0.70-0.81).ConclusionsThe PAT demonstrated encouraging preliminary reliability among experienced craniofacial orthodontists evaluating standardized PSIO records. Further multicenter studies are needed to establish broader validity and clinical applicability.
Assessment of Dentoskeletal and Airway Changes Using Hyrax and Fan-Type Expanders in Cleft Patients: An In Vivo CBCT Study.
Haritha SH, Krishna KR, Yelchuru SH … +3 more , Kumar DK, Saveri K, Sonika B
Cleft Palate Craniofac J · 2026 Jun · PMID 42377098 · Publisher ↗
ObjectiveTo compare dentoskeletal, nasal septal, and upper airway changes following rapid maxillary expansion (RME) using Hyrax and fan-type expanders in growing patients with cleft lip and palate (CLP) using cone-beam c...
ObjectiveTo compare dentoskeletal, nasal septal, and upper airway changes following rapid maxillary expansion (RME) using Hyrax and fan-type expanders in growing patients with cleft lip and palate (CLP) using cone-beam computed tomography (CBCT).DesignProspective comparative clinical study.SettingUniversity-based tertiary care dental institution.PatientsTwenty patients aged 9 to 15 years with repaired unilateral or bilateral CLP and transverse maxillary deficiency.InterventionsParticipants were treated with bonded Hyrax ( = 10) or fan-type expanders ( = 10) according to maxillary constriction pattern. CBCT scans were obtained before expansion (T0) and after a 3-month retention period (T1).Main Outcome MeasuresAnteroposterior, vertical, and transverse dentoskeletal parameters, nasal septum deviation, and oropharyngeal airway volume were evaluated. Intragroup comparisons used the Wilcoxon signed-rank test; intergroup comparisons used the Mann-Whitney test ( < .05).ResultsBoth appliances achieved significant transverse expansion. The fan-type expander showed greater anterior basal widening, whereas the Hyrax demonstrated greater posterior expansion and nasal cavity width increase. Airway volume increased but was not statistically significant.ConclusionsBoth expanders effectively correct transverse maxillary deficiency in CLP patients. Appliance selection should be based on constriction pattern. Airway effects appear limited.
Integrated Surgical Repair of an Isolated Congenital Palatal Fistula: Case Report and Brief Review.
John JR, Thakur R, Bajaj H
Cleft Palate Craniofac J · 2026 Jun · PMID 42377083 · Publisher ↗
Congenital palatal fistula is a rare embryologic anomaly, occurring in one percent of cleft cases, often causing hypernasality and nasal regurgitation. We report a 3-year-old male with an isolated fistula at the hard-sof...
Congenital palatal fistula is a rare embryologic anomaly, occurring in one percent of cleft cases, often causing hypernasality and nasal regurgitation. We report a 3-year-old male with an isolated fistula at the hard-soft palate junction. Repair was performed using a combined technique: a turnover hinge flap for the nasal layer and Z-plasty flaps for the oral layer. A fistula at this area is difficult to manage because of paucity of tissue. The two layer closure that we describe is a refinement of technique with practical applications.
Quality of Life for Children with Cleft Lip and Palate and Their Families: The Effect of Adoption from China.
Kapp-Simon KA, Albert M, Crerand CE … +4 more , Bellucci CC, Heppner CE, Woodard S, Conrad AL
Cleft Palate Craniofac J · 2026 Jun · PMID 42377082 · Publisher ↗
ObjectiveTo compare parent-proxy and child self-reported quality of life (QoL) for children with cleft lip and palate (CLP) by adoptive status from China.DesignObservational multi-site study.SettingSix North American cle...
ObjectiveTo compare parent-proxy and child self-reported quality of life (QoL) for children with cleft lip and palate (CLP) by adoptive status from China.DesignObservational multi-site study.SettingSix North American cleft treatment clinics.ParticipantsChildren with CLP ages 8.0-10.99 years and their parents (adopted from China, N = 87; not adopted, N = 167).Outcome MeasuresPediatric QoL Inventories (PedsQL): Parent, Child, Family Impact Module (FIM); CLEFT-Q.ResultsMultivariate analyses of covariance, adjusted for age, race, and socioeconomic status main effects (adoptive status, sex, and interactions of adoptive status with sex) and results were not significant by adoptive status, sex, or the interactions of adoptive status with sex for CLEFT-Q, Parent PedsQL FIM outcomes, or Parent/Child PedsQL subscale outcomes ( > .159). Parent-proxy PedsQL School was higher for females regardless of adoptive status (MD = -4.82, CI = -9.53, -.11, = .045). Child PedsQL Social QoL was higher for children adopted from China (MD = 8.91, CI = 1.18, 16.64, = .024), where females who were adopted reported higher PedsQL social scores than females who were not adopted (MD = 11.83, CI = 3.09, 20.57, = .008). Females who were adopted reported higher Cleft-Q Social scores than males who were adopted (MD = -6.95, CI = -18.54, -.54, = .038).ConclusionsChild and Family QoL was comparable between children with CLP, aged 8-10 years, who were and were not adopted. Being adopted may confer some protection for social functioning, particularly for females who are adopted.
Artificial Intelligence Applications in Cleft Lip and Palate Diagnosis, Prediction, and Treatment: A Systematic Review and Meta-Analysis.
Azimi N, Iraj SA, Mazaheri F … +4 more , Maddahi S, Khanmohammadi MM, Azadi A, Ebadifar A
Cleft Palate Craniofac J · 2026 Jun · PMID 42360076 · Publisher ↗
ObjectiveCleft lip and cleft palate are common craniofacial abnormalities, causing significant functional, esthetic, and psychosocial issues if not treated early. Artificial intelligence (AI) is increasingly explored in...
ObjectiveCleft lip and cleft palate are common craniofacial abnormalities, causing significant functional, esthetic, and psychosocial issues if not treated early. Artificial intelligence (AI) is increasingly explored in cleft lip and/or palate (CL/P); however, the quality, consistency, and clinical readiness of the available evidence remain unclear. This study systematically reviewed the existing literature on AI applications in CL/P care and performed an exploratory meta-analysis.DesignA comprehensive search was performed on PubMed, WOS, Scopus, and IEEE Xplore until November 2025, following the PECO question: "In patients with CL/P (P), how do AI approaches (E), compared with conventional diagnostic methods or human intelligence (C), perform in terms of diagnostic accuracy, predictive performance, or treatment outcomes (O)?". Studies applying AI to human CL/P data for diagnostic, predictive, or treatment purposes were included. Risk of bias was assessed using appropriate checklists (eg, QUADAS-2). Due to study heterogeneity, random-effects meta-analyses were limited to subgroups evaluating CL/P detection on panoramic radiographs and prediction of orthognathic surgery using lateral cephalograms.ResultsThe search identified 548 articles; after screening and full-text review, 52 studies were included. These studies addressed diagnosis, prediction, and treatment planning. Meta-analysis of CL/P detection indicated pooled sensitivity, specificity, and accuracy of 87%, 89%, and 90%. Prediction of orthognathic surgery showed sensitivity and specificity of 87% and 86%.ConclusionAI is increasingly applied in CL/P management, suggesting high accuracy and consistency in diagnosis, prediction, and treatment evaluation, often approaching expert-level performance.
Caregiver Experiences With Infant PLANA Therapy for Cleft Lip and/or Palate: A Cross-Sectional Survey Study.
Ricke C, Perez Rivera LR, Staffenberg DA … +2 more , Flores RL, Shetye PR
Cleft Palate Craniofac J · 2026 Jun · PMID 42360073 · Publisher ↗
ObjectiveTo evaluate caregiver experiences with presurgical lip, alveolus, and nose approximation (PLANA) therapy, including adherence, burden, support, and perceived effectiveness in infants with cleft lip and/or palate...
ObjectiveTo evaluate caregiver experiences with presurgical lip, alveolus, and nose approximation (PLANA) therapy, including adherence, burden, support, and perceived effectiveness in infants with cleft lip and/or palate.DesignCross-sectional survey study using an anonymous, voluntary questionnaire administered via Research Electronic Data Capture. Descriptive statistics were used to summarize responses, and qualitative responses were analyzed for common themes.SettingSingle tertiary care academic institution.Patients, ParticipantsCaregivers of infants with cleft lip and/or palate undergoing PLANA therapy were identified through institutional records. Of 48 eligible caregivers, 23 unique responses were included.InterventionsPLANA therapy utilizing the NoseAlign device with concurrent lip taping, applied at home with periodic clinical follow-up.Main Outcome Measure(s)Caregiver-reported adherence, training satisfaction, infant tolerance, caregiver burden, perceived support, and perceived effectiveness.ResultsCaregivers reported high satisfaction with training (73.9% very satisfied) and high adherence, with 87.0% reporting consistent use and 100% reporting daily wear. Most reported no feeding interference (86.4%) and good infant tolerance (73.9% comfortable or very comfortable). Caregiver burden was low, with 60.9% reporting minimal impact on daily routines and 78.3% reporting confidence in application. Perceived support from the medical team was uniformly high (100%). Overall, 90.9% were satisfied with outcomes, and 95.7% would recommend PLANA therapy.ConclusionsPLANA therapy demonstrates high caregiver satisfaction, strong adherence, and favorable perceived outcomes. Its simplified design may reduce caregiver burden while maintaining effectiveness. Further studies are needed to evaluate long-term outcomes and cost-effectiveness.
Assessment of the Impact of Two-Jaw Orthognathic Surgery on Three-Dimensional Airway Volume in Patients with Skeletal Class III Patterns.
Chang YJ, Hsu TC, Chan CH … +2 more , Lai JP, Lin SS
Cleft Palate Craniofac J · 2026 Jun · PMID 42340271 · Publisher ↗
ObjectiveTo evaluate 3-dimensional pharyngeal airway changes following 2-jaw orthognathic surgery in skeletal Class III patients and to assess their association with surgical movements.DesignRetrospective observational s...
ObjectiveTo evaluate 3-dimensional pharyngeal airway changes following 2-jaw orthognathic surgery in skeletal Class III patients and to assess their association with surgical movements.DesignRetrospective observational study.SettingSingle tertiary care center.PatientsTwenty-seven adult patients with skeletal Class III malocclusion who underwent Le Fort I maxillary advancement combined with bilateral sagittal split osteotomy mandibular setback.InterventionsAll patients received 2-jaw orthognathic surgery with preoperative (T0) and postoperative (T1, 6 months) computed tomography imaging.Main Outcome MeasuresThree-dimensional airway volumes of the nasopharynx, oropharynx, and hypopharynx were measured. Correlations between airway volume changes and skeletal movements were analyzed.ResultsSignificant regional differences in airway changes were observed. The nasopharyngeal airway volume increased (+1979.1 mm), while the oropharyngeal airway showed minimal change (+336.4 mm). In contrast, the hypopharyngeal airway demonstrated a significant reduction (-1087.5 mm). A strong correlation was found between mandibular setback and hypopharyngeal airway reduction at Point B (r = 0.73, = .023).ConclusionsTwo-jaw orthognathic surgery results in region-specific airway changes. Hypopharyngeal airway reduction is associated with mandibular setback, while maxillary advancement contributes to upper airway enlargement. These findings reflect morphological rather than functional changes, and further studies incorporating functional assessments are required to determine their clinical significance.
Does American Cleft Palate Craniofacial Association Cleft Team Accreditation Address Cleft Burden? A National Analysis.
Pullmann D, Groysman L, Kantar R … +2 more , Rivera LP, Flores RL
Cleft Palate Craniofac J · 2026 Jun · PMID 42340253 · Publisher ↗
National efforts promoting high-quality cleft care rely on accreditation by the American Cleft Palate-Craniofacial Association (ACPA), though accreditation does not account for regional disease burden. Using U.S. natalit...
National efforts promoting high-quality cleft care rely on accreditation by the American Cleft Palate-Craniofacial Association (ACPA), though accreditation does not account for regional disease burden. Using U.S. natality and global health datasets (2014-2021), cleft incidence, prevalence, and disability-adjusted life years (DALYs) were compared with trends in ACPA accreditation. While births and cleft incidence declined nationally, accreditation expanded substantially. Conversely, prevalence and DALYs rose regionally without corresponding increases in accredited centers. Several states demonstrated discordant trends between burden and access. These findings suggest misalignment between accredited cleft care availability and evolving geographic disease burden, underscoring the need for data-driven resource planning.
Surgical Complications in Microtia Reconstruction: An 11-Year Experience at an Academic Hospital in Surabaya, Indonesia.
Putri IL, Tanto CD, Aisyah IF … +1 more , Pramanasari R
Cleft Palate Craniofac J · 2026 Jun · PMID 42334202 · Publisher ↗
ObjectiveThis study evaluated the incidence, frequency, types, and risk factors of complications following staged autologous costal cartilage reconstruction for microtia at an academic hospital in Surabaya, Indonesia.Des...
ObjectiveThis study evaluated the incidence, frequency, types, and risk factors of complications following staged autologous costal cartilage reconstruction for microtia at an academic hospital in Surabaya, Indonesia.DesignRetrospective descriptive study.SettingAcademic hospital in Surabaya, Indonesia, serving as a national referral center for microtia.ParticipantsMedical records of 122 unique patients with microtia who underwent autologous costal cartilage reconstruction between January 2014 and December 2024 were reviewed. Patients with incomplete records were excluded.InterventionsTwo-stage autologous microtia reconstruction using a costal cartilage framework. Stage-2 elevation was performed using either a temporoparietal fascia flap (TPF) or retroauricular fascial flap (RFF).Main Outcome MeasuresIncidence and type of postoperative complications involving the reconstructed ear, donor site, and neck.ResultsPostoperative complications occurred in 38 of 122 patients (31.1%), with 47 discrete complication events recorded. Complications were more frequent after stage 1 (27 events) than stage 2 (20 events). Stage-1 complications included skin necrosis (18.1%), cartilage exposure (9.0%), cartilage resorption (7.2%), and donor-site hypertrophic scar (5.4%). Stage-2 complications included skin necrosis (7.4%), synechiae (4.4%), auricular hypertrophic scar (4.4%), donor-site hypertrophic scar (7.4%), and wire exposure (1.4%). In stage 2, complications occurred in 25 of 57 TPF patients (43.8%), whereas no complications were observed in 10 RFF reconstructions.ConclusionsAutologous microtia reconstruction carries a notable complication risk, particularly after stage 1. Smoking, tissue quality, and flap selection may influence outcomes. Careful planning, counseling, flap selection, and postoperative care are essential to minimize complications and optimize results.
Patient-Reported Outcomes and Surgical Correlates of Self-Perception in Adults with Cleft Lip and Palate: A CLEFT-Q Study.
Cruz CS, Tonello C, Ribas MDC … +1 more , Alonso N
Cleft Palate Craniofac J · 2026 Jun · PMID 42334182 · Publisher ↗
ObjectiveTo investigate the self-perception of adults with cleft lip and palate during the treatment process, analyzing correlations among sociodemographic variables, cleft types, surgical history, and satisfaction repor...
ObjectiveTo investigate the self-perception of adults with cleft lip and palate during the treatment process, analyzing correlations among sociodemographic variables, cleft types, surgical history, and satisfaction reported through the CLEFT-Q.DesignObservational, cross-sectional, and prospective study based on primary and secondary data. Correlation tests identified associations between clinical and psychosocial factors and self-perception scores obtained through the instrument.SettingNational tertiary referral hospital for craniofacial anomaly treatment, in an outpatient setting.ParticipantsFifty adults aged 18-29 years, of both sexes, with cleft lip and palate, without associated syndromes. Palate clefts and cognitive impairments that hindered assessment were excluded.InterventionsAdministration of the CLEFT-Q, composed of 13 scales covering appearance, facial function, and health-related quality of life, complemented by clinical and sociodemographic data from medical records.Main Outcome MeasuresCLEFT-Q.ResultsThe lowest mean scores were observed for nose (42.8 ± 24.9) and nostrils (44.3 ± 30.2), and the highest for jaw (71.0 ± 27.1) and lip scar (65.0 ± 25.3). Rhinoplasty was associated with higher esthetic satisfaction ( = .004; = .022). The number of palate repair correlated negatively with speech and eating domains.ConclusionsSelf-perception was related to clinical variables, particularly cleft type and surgical history. The CLEFT-Q proved essential for patient-centered care, broadening the understanding of subjective outcomes in craniofacial treatment.
Craniofacial Growth and Hypodontia in Individuals Born with Van der Woude Syndrome.
Vesterbacka M, Parikakis K, Ganzer N … +2 more , Karsten A, Pegelow M
Cleft Palate Craniofac J · 2026 Jun · PMID 42334064 · Publisher ↗
ObjectiveTo study craniofacial growth and hypodontia in individuals born with Van der Woude syndrome (VWS) and compare with matched controls with and without a cleft.DesignA multicenter retrospective case-control study.S...
ObjectiveTo study craniofacial growth and hypodontia in individuals born with Van der Woude syndrome (VWS) and compare with matched controls with and without a cleft.DesignA multicenter retrospective case-control study.SettingIndividuals from three craniofacial centers in Sweden and from a historical archive of Swedish healthy children were included.PatientsSixty individuals, with VWS (n = 20), non-syndromic cleft lip and/or palate (NSCL/P) (n = 20), and healthy controls (CTR) (n = 20), matched for age, gender and cleft type.InterventionsTwo lateral cephalograms per individual, taken at 10 and 16 years of age, were analyzed. Orthopantomograms were used to evaluate hypodontia.Main Outcome MeasuresCraniofacial growth followed longitudinally, with the primary variables SNA, SNB, ANB, NL/ML, and maxillary length. Prevalence of hypodontia was also recorded.ResultsMaxillary length increased 0.3 mm in the VWS group during puberty, compared to 4 mm in the NSCL/P group and 5.5 mm in the CTR group. Both cleft groups had a retruded maxilla at 16 years of age. The change in vertical jaw relation from 10 to 16 years showed a statistically significant difference between the VWS and the CTR group, with a slightly more posteriorly inclined mandible in the VWS group at 16 years. A statistically significant difference in hypodontia is seen between the cleft groups. In the VWS group, 90% had hypodontia compared to 60% in the NSCL/P group.ConclusionIndividuals born with VWS have reduced maxillary growth during puberty and a higher prevalence of hypodontia compared to matched controls in the studied population.
Buccinator Flaps Palatal Lengthening and Posterior Positioning of the Velar Muscles as a Combined Procedure for VPI Management.
Elsherbiny A, Mazeed AS
Cleft Palate Craniofac J · 2026 Jun · PMID 42329955 · Publisher ↗
This letter is about a recent publication in the Cleft Palate Craniofacial Journal titled: "Posterior Positioning of Levator Veli Palatini with Intact Nasal Layer and Side-by-Side Bilateral Buccinator Flaps: Modified App...
This letter is about a recent publication in the Cleft Palate Craniofacial Journal titled: "Posterior Positioning of Levator Veli Palatini with Intact Nasal Layer and Side-by-Side Bilateral Buccinator Flaps: Modified Approach for Palatal Lengthening" in which the authors present a 'modified' technique combining both palatal lengthening with buccinator flaps and velar muscles posterior positioning. However, earlier publications including two peer-reviewed articles and a book chapter had already introduced the same conceptual combination, yet these were not cited.We discuss the technical differences among these procedures, as well as the potential advantages and disadvantages of each. These differences include whether buccinator flaps are used to lengthen only the oral mucosa or both the oral and nasal layers, and whether the velar muscle is dissected in isolation or maintained attached to either the nasal or oral mucosa during retropositioning. Current evidence remains insufficient to determine whether oral-only or dual-layer lengthening provides superior outcomes, or which muscle dissection technique achieves more reliable velopharyngeal competence, as existing studies are limited by relatively small and heterogeneous cohorts, variations in assessment methods, and inconsistent follow-up durations. Further comparative studies are needed to clarify the optimal technique for combining buccinator palatal lengthening with muscle repositioning.
Facing Empathy: Reducing Facial-Differences Bias Through a Story.
Chouinard B, Cheuk M, Hodgetts W … +1 more , Cummine J
Cleft Palate Craniofac J · 2026 Jun · PMID 42329878 · Publisher ↗
ObjectiveThis study investigated if an empathy-evoking vignette could reduce facial differences bias, while considering gender.DesignParticipants (N = 124) were randomly assigned to read either an empathy-evoking vignett...
ObjectiveThis study investigated if an empathy-evoking vignette could reduce facial differences bias, while considering gender.DesignParticipants (N = 124) were randomly assigned to read either an empathy-evoking vignette or nothing, after which they completed indirect and direct bias measures.SettingThe study was conducted entirely online.ParticipantsThose completing the study were members of the general public, none of which had a facial difference.InterventionsParticipants either read a short, empathy-evoking vignette or nothing before then completing the tasks.Main Outcome MeasuresThe indirect measure of bias was an implicit association task. Explicit measures of bias were questions about preferences and attitudes toward people with facial differences.ResultsReading the vignette led to lower bias on indirect and direct measures in females, whereas in the small sample of males, vignette males tended toward greater bias than no-vignette males. Although we tried to expand insights into bias in different genders, we did not have enough non-binary participants.ConclusionThis study showed that empathy-evoking vignettes can attenuate facial differences bias in females but may inadvertently heighten bias in males, underscoring the moderating role of gender in narrative-based interventions. Future work should explore diverse narrative types and perspectives, using a wider range of stimuli (varied facial differences, genders, ethnicities) and participant genders, and should incorporate gender into analyses of bias.
Comparison of the Velopharyngeal Insufficiency Effects on Life Outcomes-Parent Version with Perceptual and Instrumental Assessments.
Wombacher NR, Sommer CL, Skirko JR … +1 more , Scherer NJ
Cleft Palate Craniofac J · 2026 Jun · PMID 42329870 · Publisher ↗
ObjectiveThe purpose of this study was to examine the association between quality of life (QOL) as measured by the Velopharyngeal Insufficiency Effects on Life Outcomes-Parent Version (VELO-P), the intelligibility in con...
ObjectiveThe purpose of this study was to examine the association between quality of life (QOL) as measured by the Velopharyngeal Insufficiency Effects on Life Outcomes-Parent Version (VELO-P), the intelligibility in context scale (ICS), percent consonants correct (PCC), nasalance scores, and ratings from the Cleft Audit Protocol for Speech-Augmented- Americleft Modification (CAPS-A-AM).DesignCross-sectional design.SettingOutpatient pediatric cleft-craniofacial clinic.Participants30 children, <8 years of age, diagnosed with cleft palate with or without cleft lip (CP ± L) and their parents.Main Outcome MeasureThe VELO-P was administered to 30 parents of children with CP ± L as part of their child's annual cleft team evaluation. The VELO-P was then correlated with the ICS, CAPS-A-AM ratings, PCC, and nasalance scores. Ratings were completed by 3 speech-language pathologists (SLPs). Reliability was completed by 2 SLPs. Linear regression identified predictors of the Emotional Impact domain of the VELO-P.ResultsThe ICS had a strong correlation with the VELO-P total score ( = 0.72, < .001). As SLP ratings of speech acceptability decreased, there was an increase in the perceived QOL. The speech acceptability rating had a significant moderate correlation with the VELO-P total score ( = -0.48, = .01), Speech Limitations domain ( = -0.46, = .01), emotional impact ( = -0.41, = .03), and the Caregiver Impact domain ( = -0.40, = .04).ConclusionThe correlations between VELO-P and ICS offer insight into how speech intelligibility impacts QOL, while the CAPS-A-AM ratings offer insight into the relationship between parent and SLP perceptions of speech. Future studies should expand samples and age ranges to further examine these correlations.
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