{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:41:52Z","timestamp":1773099712544,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR001450"],"award-info":[{"award-number":["UL1 TR001450"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the utility of preoperative imaging before velopharyngeal dysfunction (VPD) surgery in children with 22q11 Deletion Syndrome (22qDS) in evaluating internal carotid artery (ICA) medialization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Scopus, and CINAHL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, a systematic review was performed. Studies of children with 22qDS who underwent preoperative imaging (MRA or CTA) to identify ICA anomalies were included. High\u2010risk medialized ICAs were defined as either submucosal, retropharyngeal, Pfeiffer Grade III\u2010IV, or &lt;3\u2009mm from the pharyngeal mucosa. Meta\u2010analyses of proportions were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies met inclusion criteria, comprising 398 patients with 22qDS (weighted mean age 7.6\u2009years). In 372 patients with imaging, the rate of ICA medialization on imaging was 47.1% (95%CI 29.2\u201365.5), of which 46.3% (95%CI 27.4\u201365.8) were determined high risk. Operative plans were modified in 19.4% (95%CI 5.7\u201338.8) of 254 surgeries due to medialized ICA. In studies attempting to use nasopharyngoscopy pulsations to identify medialization for 214 patients, the true\u2010positive rate was 53.9% (95%CI 27.5\u201379.2) and the false\u2010positive rate was 16.2% (95%CI 7.9\u201326.8). Nine of eleven studies (81.8%) recommended universal preoperative imaging of the ICAs in children with 22qDS undergoing VPD surgery. No cases of perioperative bleeding secondary to ICA injury were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although most studies endorse routine preoperative imaging to assess for ICA medialization in children with 22qDS undergoing VPD surgery, only a minority of these cases led to surgical modification. Additional studies are needed to compare outcomes in children with and without preoperative imaging given the low rates of ICA injury in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      N\/A\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:2551\u20132561, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31181","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T07:44:24Z","timestamp":1701762264000},"page":"2551-2561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preoperative Imaging in Patients with 22q11 Deletion Syndrome Undergoing Velopharyngeal Surgery"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6944-9752","authenticated-orcid":false,"given":"Kelsey A.","family":"Duckett","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6907-488X","authenticated-orcid":false,"given":"Nicolas S.","family":"Poupore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1081-4772","authenticated-orcid":false,"given":"Phayvanh P.","family":"Pecha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200110000-00014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110236"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.40637"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4613"},{"issue":"1","key":"e_1_2_7_7_1","first-page":"964","article-title":"Molecular genetic study of the frequency of monosomy 22q11 in DiGeorge syndrome","volume":"51","author":"Carey A","year":"1992","journal-title":"Am J Hum Genet"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.1.101"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/9.16.2421"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a3c14b"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.12.1408"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.10.016"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199804050-00005"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.03.012"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(98)00067-6"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00451-4"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000206377.14083.ce"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.134.11.1159"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198709000-00039"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1597\/03-063.1"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.02.007"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199804010-00002"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198709000-00002"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620904514"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.4.2.73"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2010.03.006"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199804050-00003"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1597\/01-110"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199604001-00005"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1597\/13-206"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199612000-00009"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/scs.0000000000004859"},{"issue":"8","key":"e_1_2_7_33_1","first-page":"586","article-title":"Vascular abnormalities in the head and neck area in velocardiofacial syndrome","volume":"27","author":"Lai JP","year":"2004","journal-title":"Chang Gung Med J"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_7_35_1","unstructured":"Oxford Centre for Evidence\u2010Based Medicine.The Oxford Levels of Evidence 2. 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