{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:52:07Z","timestamp":1778802727549,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>In wide palatal defects, closure of the nasal layer can prove a considerable challenge. Mobilizing nasal flaps posteriorly usually facilitates soft palate closure. However, the defect is often too wide within the hard palate; hence, bilateral vomerine flaps are frequently required. Despite this, there is often a small defect in the nasal layer at the posterior septum (typically equating to the hard-soft palate junction), which has to be left to heal by secondary intention with the resulting increased risk of fistula formation and the potential deleterious long-term effect on speech due to cicatricial migration of the reconstructed levator sling anteriorly. We describe our experience in the use of the sphenoid flap to obtain tension-free primary closure of the nasal layer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective multi-center study assessing all sphenoid flap procedures undertaken at both Birmingham Children\u2019s Hospital and Great Ormond Street Hospital. Key demographic and medical data was collected pre-, peri-, and postoperatively across the 2 sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 66 patients underwent the use of a sphenoid flap to aid closure of the nasal layer. The average age at time of repair was 9.7 months. More than half (55%, n = 36) were isolated cleft palates, and 35% (n = 23) were BCLPs. Forty-two percent of all patients had Robin sequence. The average cleft width was 14.4 mm. The overall fistula rate was 25.8% (n = 17).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We describe the operative technique, indications, and our experience in the use of the sphenoid flap in wide cleft palate repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617732781","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T13:03:16Z","timestamp":1518526996000},"page":"437-441","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Use of the Sphenoid Flap in Repair of the Wide Cleft Palate"],"prefix":"10.1177","volume":"55","author":[{"given":"Khurram","family":"Khan","sequence":"first","affiliation":[{"name":"West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children\u2019s Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Hardwicke","sequence":"additional","affiliation":[{"name":"West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children\u2019s Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rimante","family":"Seselgyte","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Morris","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Thorburn","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loshan","family":"Kangesu","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc C.","family":"Swan","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Richard","sequence":"additional","affiliation":[{"name":"West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children\u2019s Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"bibr1-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318254b2dc"},{"key":"bibr2-1055665617732781","first-page":"2:e81","volume":"5","author":"Bykowski MR","year":"2015","journal-title":"Cleft Palate Craniofacl J"},{"key":"bibr3-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000548"},{"key":"bibr4-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2009.10.033"},{"key":"bibr5-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1179\/1465313313Y.0000000086"},{"key":"bibr6-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198406000-00006"},{"key":"bibr7-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1597\/09-069"},{"key":"bibr8-1055665617732781","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2008.05.048"},{"key":"bibr9-1055665617732781","unstructured":"Thomas G, Swan M, Goodacre T, Cadier M. 2011. A national audit of U.K. bilateral cleft lip & palate outcomes. Unpublished data, National Meeting Presentation."}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665617732781","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1055665617732781","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665617732781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:22:51Z","timestamp":1777393371000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1055665617732781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,14]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1177\/1055665617732781"],"URL":"https:\/\/doi.org\/10.1177\/1055665617732781","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,14]]}}}