The Cleft Palate-Craniofacial Journal (CLEFT PALATE-CRAN J )

Publisher: American Cleft Palate-Craniofacial Association

Journal description

The Cleft Palate-Craniofacial Journal is an international, interdisciplinary journal reporting on clinical and research activities in cleft lip/palate and other craniofacial anomalies, together with research in related laboratory sciences. It is the journal of The American Cleft Palate-Craniofacial Association.

Current impact factor: 1.24

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2011 Impact Factor 0.822
2010 Impact Factor 0.77
2009 Impact Factor 0.884
2008 Impact Factor 0.962
2007 Impact Factor 0.962
2006 Impact Factor 0.724
2005 Impact Factor 0.574
2004 Impact Factor 0.861
2003 Impact Factor 0.888
2002 Impact Factor 0.523
2001 Impact Factor 0.686
2000 Impact Factor 0.718
1999 Impact Factor 0.994
1998 Impact Factor 0.658
1997 Impact Factor 0.699
1996 Impact Factor 0.579
1995 Impact Factor 0.53
1994 Impact Factor 0.785
1993 Impact Factor 0.629
1992 Impact Factor 0.815

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.51
Cited half-life 0.00
Immediacy index 0.19
Eigenfactor 0.00
Article influence 0.43
Website Cleft Palate-Craniofacial Journal, The website
Other titles The Cleft palate-craniofacial journal, Cleft palate craniofacial journal
ISSN 1055-6656
OCLC 23093057
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective : To gather data from relevant experimental and observational studies to determine the relationship between micrognathia and cleft palate. The goal is to raise awareness and motivate clinicians to consider the cause and effect relationship when confronted with patients with cleft palate, even if there is no clearly noticeable mandibular abnormality. Design : Several electronic databases were systematically examined to find articles for this review, using search terms including "cleft palate," "micrognathia," "tongue," and "airway obstruction." PubMed was the source of all the articles chosen to be included. Exclusion criteria included case reports, articles focused on treatment options, and articles only tangentially related to cleft palate and/or micrognathia. Results : A total of 930 articles were screened for relevance, and 82 articles were chosen for further analysis. Evidence gathered in this review includes a variety of etiological factors that are causative or associated with both micrognathia and cleft palate. Observational studies relating the two abnormalities are also included. Much of the included literature recognizes a cause-and-effect relationship between micrognathia and cleft palate. Conclusion : On the basis of the published data, we suggest that micrognathia does induce cleft palate in humans and animals. With knowledge of this causative relationship, clinicians should consider the importance of gathering cephalometric data on the mandibles and tongues of patients presenting with isolated cleft palate to determine whether they have micrognathia as well. With more data, patterns may emerge that could give insight into the complex etiology of nonsyndromic cleft palate.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Objective : Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP). Design : Retrospective cross-sectional study. Patients : Children with cUCLP. Methods : Preoperative cleft lip measurements were made at the time of primary cheiloplasty and available for each patient. Maxillary growth was evaluated on lateral cephalometric radiographs taken prior to any orthodontic treatment and alveolar bone grafting (8.5 ± 0.7 years). The presence of associations between preoperative cleft lip measurements and cephalometric measures of maxillary growth was determined using regression analyses. Results : In the 58 patients included in the study, the cleft lateral lip element was deficient in height in 90% and in transverse width in 81% of patients. There was an inverse correlation between cleft lateral lip height and transverse width with a β coefficient of -0.382 (P = .003). Patients with a more deficient cleft lateral lip height displayed a shorter maxillary length (β coefficient = 0.336; P = .010), a less protruded maxilla (β coefficient = .334; P = .008), and a shorter anterior maxillary height (β coefficient = 0.306; P = .020) than those with a less deficient cleft lateral lip height. Conclusions : Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and heights.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Background: Growing up with a cleft lip and/or palate presents a number of challenges for those affected and their families. Understanding why some individuals cope well while others struggle is key to psychological research in this field. A better appreciation of the factors and processes that contribute to psychological adjustment to cleft lip and/or palate (CL/P) from the patient perspective would be of value to both researchers and clinicians. Design: Qualitative data elicited from individual interviews with 52 adults born with CL/P. Results: Inductive thematic analysis identified three main themes: “background” factors (age, gender, sexual orientation, culture, additional conditions, socioeconomic status, and adoption), “external” factors (treatment autonomy, familial coping and support, salience, public understanding, psychological input, and peer support), and “internal” psychological factors (perceptions of difference, noticeability and teasing, social confidence, internalization of beauty ideals, valence, expectations of treatment, responding to challenges, social comparisons, acceptance, faith, dispositional style, and recognition of strengths and positive growth). Conclusions: The number and breadth of factors identified in this study are testament to the importance of psychology in the field of CL/P and may offer guidance in relation to developing and assessing the value of psychological interventions. There is a clear role for psychologists in tackling appearance-related concerns, designing materials, supporting patient decision making, and improving social interaction, as well as providing specialist psychological support. The findings illustrate the potential degree of individual variation in perspectives and offer insight into the conflicting results found within current literature. KEY WORDS: adults, cleft lip and palate, intervention, psychological adjustment, resilience, risk
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: In severe syndromic craniosynostosis, distraction osteogenesis (DO) provides superior segmental advancement and allows progressive clinical monitoring to ensure that adequate skeletal expansion is achieved. We report two cases of Crouzon syndrome involving a 3-year-old boy and a 4-year-old girl, who were both treated with monobloc Le Fort III DO using a combination of external and internal distraction devices (Synthes, Oberdorf, Switzerland) to treat severe orbital proptosis and obstructed nasopharyngeal airway secondary to severe hypoplastic craniofacial skeletal components. Their skeletal segments were advanced in daily increments by 27 mm and 23 mm, respectively. Results at 18 months postoperatively showed successful outcomes, as evidenced by adequate eye protection, tracheostomy tube decannulation following objective evidence of patent nasopharyngeal airway, and acceptable facial appearance. Monobloc Le Fort III DO using a combination of external and internal devices produces favorable functional and clinical outcomes for the treatment of severe orbital and airway discrepancy in Crouzon syndrome.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Objective : To analyze surgical complications after primary cleft palate repair in a setting with limited resources. Patients and Design : A total of 1608 consecutive cleft palate repairs with 1408 follow-ups, operated upon between 2011 and 2013, were reviewed retrospectively through medical records. Patients were 10 months to 50 years old at the time of surgery, with a median age of 9 years. Setting : Guwahati Comprehensive Cleft Care Center, Guwahati, India. Intervention : Primary cleft palate repair. Main Outcome Measures : Postoperative complications in terms of necrosis, dehiscence, fistula, infection, and "hanging palate" were assessed, as was perioperative bleeding. Logistic regression was used with complication (yes/no) as the binary dependent variable and with age, cleft type, and surgeon (visiting/long-term) as covariates. Results : The overall incidence of postoperative complications was 16.9% with a fistula rate of 13.6%. The incidence of perioperative bleeding was 1.8%. Logistic regression analysis identified cleft severity (P ≤ .001) and visiting surgeon (P ≤ .01) as factors related to the incidence of postoperative complications. Age at surgery was related to both the incidence of postoperative complications (P ≤ .001) and perioperative bleeding (P < .05). Conclusion : Due to increased risks of surgical complications, older patients with complete clefts should only be operated upon after careful consideration. In addition, these patients should be assigned to surgeons experienced with this cleft type.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Objective : To identify whether laypeople and professionals rate the facial appearance of patients with cleft lip and palate (CLP) similarly based on viewing full facial images. Design : Several electronic databases were searched. A hand search was performed among reference lists and relevant journals. Studies that assessed the full facial appearance of patients with CLP based on two-dimensional (2D) photographs, 3D images, or clinical examination by laypeople and professionals using a visual analog scale (VAS) or a categorical rating scale were included. Two authors independently assessed articles using methodologic-quality scoring protocol. Results : Eleven articles were included in qualitative synthesis, including four high-level and seven moderate-level papers. Three studies found that laypeople were more critical than professionals, three found there was no significant difference between laypeople and professionals, and five reported that professionals were more critical than laypeople when assessing facial appearance of patients with CLP. Conclusions : It still remains unknown whether laypeople are more or less critical than professionals when rating facial appearance of patients with repaired CLP. Professionals are more familiar with the esthetic outcomes and difficulties of treating patients. The opposite maybe true for laypeople; this disparity between what is achievable by professionals and what is expected by laypeople may be a source of dissatisfaction in facial appearance outcome. Further well-designed studies should be carried out to address this question and the clinical significance of the difference in rating scores for patients with CLP.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Bilateral cleft lip and palate occurs in 9.2% of cleft patients. Many approaches have been adopted to manage the protrusive premaxillary segment in patients with bilateral cleft lip and palate. Some advocate the use of intraoral appliances, occasionally combined with invasive surgery, which often requires revision at a later date. The authors describe the case of a 3-year-old child born with bilateral cleft lip and palate presenting with a protuberant premaxilla and an overjet greater than 25 mm. Prompt intervention was warranted in this case due to the potential for traumatic compromise to the dentition of the premaxillary segment and a distinct lack of social integration reported by the parents. The patient was managed with a novel, innovative approach using orthodontic traction and minimally invasive surgery. The literature has been reviewed and the patient's subsequent physiological and psychosocial development has been monitored. He has since undergone successful alveolar bone grafting.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Objective : Children with nonsyndromic cleft lip and/or palate often have a high prevalence of middle ear dysfunction. However, there are also indications that they may have a higher prevalence of (central) auditory processing disorder. This study used Fisher's Auditory Problems Checklist for caregivers to determine whether children with nonsyndromic cleft lip and/or palate have potentially more auditory processing difficulties compared with craniofacially normal children. Methods : Caregivers of 147 school-aged children with nonsyndromic cleft lip and/or palate were recruited for the study. This group was divided into three subgroups: cleft lip, cleft palate, and cleft lip and palate. Caregivers of 60 craniofacially normal children were recruited as a control group. Hearing health tests were conducted to evaluate peripheral hearing. Caregivers of children who passed this assessment battery completed Fisher's Auditory Problems Checklist, which contains 25 questions related to behaviors linked to (central) auditory processing disorder. Results : Children with cleft palate showed the lowest scores on the Fisher's Auditory Problems Checklist questionnaire, consistent with a higher index of suspicion for (central) auditory processing disorder. There was a significant difference in the manifestation of (central) auditory processing disorder-linked behaviors between the cleft palate and the control groups. The most common behaviors reported in the nonsyndromic cleft lip and/or palate group were short attention span and reduced learning motivation, along with hearing difficulties in noise. Conclusion : A higher occurrence of (central) auditory processing disorder-linked behaviors were found in children with nonsyndromic cleft lip and/or palate, particularly cleft palate. Auditory processing abilities should not be ignored in children with nonsyndromic cleft lip and/or palate, and it is necessary to consider assessment tests for (central) auditory processing disorder when an auditory diagnosis is made for this population.
    The Cleft Palate-Craniofacial Journal 02/2015;
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    ABSTRACT: Noonan syndrome, characterized by short stature, facial anomalies, and congenital heart defects, may also be associated with hematopoietic disorders. Craniofacial anomalies in affected patients include hypertelorism and severe open bite associated with masticatory dysfunction. We treated a Noonan syndrome patient with a skeletal open bite. Surgical orthodontic treatment including two-jaw surgery established a good occlusal relationship after correction of severe anemia. Both upper and lower incisors were moved to upright positions, while clockwise rotation of the palatal plane and decreased mandibular plane angle were accomplished. Lower masticatory activity may affect posttreatment occlusion in such cases.
    The Cleft Palate-Craniofacial Journal 01/2015;
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    ABSTRACT: Objective : To study the growth of length-for-age (L/A), weight-for-age (W/A), and body mass index (BMI) of children with cleft lip and palate receiving a normal diet; to establish specific growth curves for children with cleft palate with or without cleft lip (CLP/ICP) who had not undergone palatoplasty and for children with isolated cleft lip (ICL); and to assess if CLP/ICP growth differed from ICL growth and if CLP/ICP and ICL growth differed from growth for typical children. Design : Prospective and cross-sectional study. Setting : Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. Main Outcome Measures : Weight and length of 381 children with cleft lip and palate and who were younger than 2 years were recorded and used to calculate W/A, L/A, and BMI growth curves. The 2006 World Health Organization growth charts were used as a reference for typical children. All children received a normal diet for age. Results : Children with CLP/ICP had median W/A and BMI growth curves below growth curves for typical children but showed spontaneous recovery starting at approximately 5 months of age, even with nonoperated cleft palate. Children with ICL had growth similar to that of typical children. Children with CLP/ICP, who initially had W/A and BMI values less than those of the ICL group, had W/A and BMI equal to or higher than the ICL group after 9 months of age. Conclusion : Children with CLP/ICP had impaired W/A and BMI growth with spontaneous recovery starting early in childhood. This study established specific W/A, BMI, and L/A growth curves for children with cleft lip and palate.
    The Cleft Palate-Craniofacial Journal 01/2015;
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    ABSTRACT: Objective : To describe Pierre Robin sequence patients with a cleft palate from a multidisciplinary perspective. Patients : A total of 104 individuals with Pierre Robin sequence and cleft palate, born between 1980 and 2010. Method : Data were collected retrospectively and compared with large control groups. Results : Of 104 patients, 19 (18.3%) were treated with a nasopharyngeal or oropharyngeal tube, continuous positive airway pressure, and/or a tracheotomy. The mean weight percentile for newborns with Pierre Robin sequence was 30.9. It decreased to 29.9 at the time of cleft palate repair (mean age, 13.7 months) (P = .78). Of 87 patients, 30 (34.5%) developed normal speech after cleft palate repair. Of 93 nonsyndromic Pierre Robin sequence patients, 31 (33.3%) had or are having surgery for velopharyngeal insufficiency, a rate that is significantly higher when compared with a control group of cleft palate-only patients (19.4%; P = .004). Of 31 patients, 25 (80.6%) developed normal resonance after surgery for velopharyngeal insufficiency. There was no significant difference in the rate of syndromes between the Pierre Robin sequence patients and a control group of cleft palate patients without Pierre Robin sequence (P = .25). Seven of 39 boys (17.9%) with Pierre Robin sequence had a diagnosis of autism spectrum disorder. Conclusion : Even though the mean weight percentile for newborns with Pierre Robin sequence was low, the patients did not show a growth spurt during the first year of life. The high rate of velopharyngeal insufficiency after cleft palate repair in patients with Pierre Robin sequence needs further investigation. Also, the high rate of autism spectrum disorder among boys with Pierre Robin sequence prompts further investigation.
    The Cleft Palate-Craniofacial Journal 01/2015;
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    ABSTRACT: Objective: To explore the impact of having a child born with a cleft lip and/or palate from the father's perspective. Design: Individual qualitative telephone interviews. Participants: A total of 15 fathers of children born with cleft lip and/or palate were recruited throughout the U.K. via advertisements. Results: Supported by a number of subthemes, four overarching themes were identified: variations in care and support; appraisals of the cleft; perceptions of treatment; and looking back and moving forward. Conclusions: Fathers reported experiences comparable to those previously reported by mothers, in addition to a number of further support and information needs. Participants played a key role in supporting their families through the treatment process, yet fathers are underrepresented in the research literature. Recommendations are made for the adequate inclusion of fathers in future research and in relation to methods of support for fathers through their children's diagnosis and treatment. (E-pub December 2013)
    The Cleft Palate-Craniofacial Journal 01/2015; 52(1):31-43.
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    ABSTRACT: Objective : Our aim was to evaluate dental/orthodontic outcomes for patients who underwent recombinant human bone morphogenic protein (rhBMP-2) alveolar cleft repair and to examine parental satisfaction following the procedure. Design : Retrospective review. Setting : Tertiary children's hospital. Participants : Parents, dentists, and orthodontists completed satisfaction questionnaires. Main Outcome Measures : Parent, dentist, and orthodontist satisfaction with the use of rhBMP-2 in alveolar cleft repair. Results : Parent response rate was 71.4% (30/42). The dentist response rate was 60% (18/30). The orthodontist response rate was 53.3% (16/30). Parent and patient satisfaction was 93.3% and 83.3%, respectively. Of dentist respondents, 55.6% reported that the bone quality and alveolar ridge mucosal repair allowed for dental treatment. Of orthodontist respondents, 87.5% reported the graft enabled treatment, and 73.3% felt the graft prevented tooth root exposure and resorption. Conclusions : Parents, dentists, and orthodontists are satisfied with outcomes when rhBMP-2 is used for alveolar cleft repair. The bone formed was reported as adequate to support dental and orthodontic treatment in most cases with few complications. Because of safety concerns over the use of this product in an off-label manner, further controlled studies are warranted.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: This case report presents the management of a female patient with unilateral cleft lip and palate presenting with skeletal Class III malocclusion and a narrow upper dental arch with a midline deviation. The treatment plan involved asymmetric transverse distraction osteogenesis of the maxilla to make the upper dental midline coincident with the facial midline. After the treatment, a good facial profile and a close intercuspation of teeth were achieved. Occlusion remained stable with normal overjet and overbite after 2-year retention.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: Objective : To assess the effect of tranexamic acid on the quality of the surgical field. Design : Prospective, randomized, double-blind study. Setting : Institutional, tertiary referral hospital. Participants : American Society of Anesthesiologists physical status class I patients, aged 8 to 60 months with Group II or III (Balakrishnan's classification) clefts scheduled for cleft palate repair. Interventions : Children were randomized into two groups. The control group received saline, and the tranexamic acid group received tranexamic acid 10 mg/kg as a bolus, 15 minutes before incision. Main Outcome Measures : Grade of surgical field on a 10-point scale, surgeon satisfaction, and primary hemorrhage. Results : Significant improvements were noted in surgeon satisfaction and median grade of assessment of the surgical field (4 [interquartile range, 4 to 6] in the control group vs 3 [interquartile range, 2 to 4] in the test group; P = .003) in the tranexamic acid group compared to the control group. Conclusion : Preincision administration of 10 mg/kg of tranexamic acid significantly improved the surgical field during cleft palate repair.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: Objective : To evaluate the reproducibility of three nonverbal facial expressions using a three-dimensional motion capture system. Design : Prospective, cross-sectional, controlled study. Setting : Glasgow Dental Hospital and School, University of Glasgow, United Kingdom. Patients and Participants : Thirty-two subjects, 16 males and 16 females. Methods : With a three-dimensional video passive stereophotogrammetry imaging system, maximal smile, cheek puff, and lip purse were captured for each subject. Anatomical facial landmarks were digitized on the first frame and then tracked automatically. The same facial expressions were captured 15 minutes later. Main Outcome Measures : The magnitude of each expression and speed of landmark displacement were calculated. The landmark motion curves were spatially and temporally aligned to calculate the similarity of the dynamic movements of the same landmarks between the captures. Results : There were no significant differences between individuals for magnitude (P = .892) or for speed (P = .456). There were significant differences in landmark movement similarity (P = .011); similarity was more reproducible for maximal smile. There was no significant gender effect on the difference in magnitude. There was a significant gender effect on speed to reach maximal smile (P = .044) and a pursed-lip expression (P = .038). There was a significant gender effect on landmark movement similarities (P = .031) for cheek puff expression. Conclusions : There were no differences in magnitude and speed for maximal smile, cheek puff, and lip purse between the two captures for all participants. For individual expressions, maximal smile expression had the highest similarity value for individual landmarks.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: Design : Observations of wild chimpanzees ( Pan troglodytes schweinfurthii) were conducted in Kibale National Park, Uganda, at the sites of Sebitoli and Ngogo. Results : We report the first two cases of cleft lip in wild chimpanzees. Additionally, some other chimpanzees in the Sebitoli community show facial dysplasia and congenital anomalies, such as patches of depigmented hairs and limb defects. Conclusions : Cleft lip has been documented in several species of nonhuman primates, but much remains unknown about the occurrence of cleft lip and cleft palate in great apes, probably because such malformations are rare, wild apes are difficult to monitor and observe, and severe cases associated with cleft palates render suckling impossible and lead to early death of infants. The genetic basis of such defects in great apes warrants investigation, as does the possibility that environmental toxins contribute to their etiology in Kibale in ways that could affect humans as well.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: Objective : To examine the occurrence of complications in patients with congenital facial anomalies who underwent orthognathic surgeries and to identify the role of patient-related factors in occurrence of complications. Design : Retrospective analysis of hospital discharge database. Setting : Nationwide inpatient sample for the years 2004 to 2010. All patients with a diagnosis of cleft lip and/or palate or congenital craniofacial anomalies and who had an orthognathic surgery were selected. Interventions : Orthognathic surgery. Main Outcome Measures : Occurrence of complications. Results : During the study period, a total of 8340 patients with congenital craniofacial anomalies underwent orthognathic surgeries. The overall complication rate was 9.1%. Six different complications (bacterial infections, hemorrhage, postoperative pneumonia, iatrogenic-induced complications such as accidental punctures/lacerations or pneumothorax, other infections, and respiratory complications) occurred in at least 1% of all patients having orthognathic surgeries. Ninety-five percent of patients were discharged routinely after surgery. Patients with high comorbid burden are at a higher risk for developing complications (P < .05). Conclusions : The current study findings indicate that orthognathic surgeries can be safely performed in patients with congenital craniofacial anomalies. The present study results reflect the practice patterns and hospitalization outcomes across the country and could serve as benchmarks for future well-designed prospective controlled studies to examine risk factors associated with complications for not only orthognathic surgeries but also for a wider range of surgical procedures.
    The Cleft Palate-Craniofacial Journal 12/2014;
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    ABSTRACT: Objective : The aim of this study is to evaluate the nasopharyngeal airway volumes of patients with unilateral cleft lip and palate (UCLP) with different GOSLON scores. Methods : The study sample consisted of 34 patients with UCLP and 20 controls with no cleft history. In the UCLP group, three experienced examiners used the GOSLON Yardstick to rate dental arch relationships, and the sample was divided into three groups as GOSLON 2 (G2) (n = 13), GOSLON 3 (G3) (n = 10), and GOSLON 4 (G4) (n = 11). Airway volumes were constructed using three-dimensional computed tomography data and divided into four compartments named the nasal airway, and superior, middle, and inferior pharyngeal airways. Results : No statistically significant difference was detected among G2, G3, and G4 between the constitutive airway departments of the nasopharyngeal region. However, nasal airway volumes were significantly higher in the control group when compared with the UCLP group. Discussion : Although there was no correlation among the investigated parameters, it is also a fact that airway capacities display a great variability among patients when investigated three dimensionally. Conclusion : Although the severity of GOSLON scores might predetermine the extent of which the airways are affected from the cleft, a larger sample size is needed in future studies.
    The Cleft Palate-Craniofacial Journal 12/2014;