{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:39:10Z","timestamp":1791967150763,"version":"4.3.4"},"reference-count":81,"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>This systematic review sought to evaluate the consensus in the literature regarding the surgical management of VPD and to determine whether a particular procedure results in superior speech outcome or less morbidity<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A systematic review was carried out according to PRISMA-P guidelines. Systematic review software was used to facilitate 3-stage screening and data extraction by 2 reviewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>University teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants:<\/jats:title>\n                    <jats:p>Studies that reported perceptual speech assessment or obstructive sleep apnea (OSA) in patients who had undergone surgery for VPD were included in the review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Four categories of surgery for VPD were examined\u2014pharyngeal flap, sphincter pharyngoplasty, palatoplasty, and posterior pharyngeal wall augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures:<\/jats:title>\n                    <jats:p>Perceptual speech assessment, need for further surgery, and occurrence of OSA were the outcomes of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-three relevant studies were identified, comprising data on 4011 patients. Pharyngeal flap was the most common procedure (64% of patients). Overall, 70.7% of patients attained normal resonance and 65.3% attained normal nasal emission. There was no notable difference in speech outcomes, need for further surgery, or occurrence of OSA across the 4 categories of surgery examined. Heterogeneous groups of patients were reported upon and a variety of perceptual speech assessment scales were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There is a lack of consensus in the literature to guide procedure selection for patients with VPD. The development of a standardized minimum data set to record postoperative speech, OSA, and patient-reported outcomes is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617735102","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T13:03:16Z","timestamp":1518526996000},"page":"405-422","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":105,"title":["Surgery for Velopharyngeal Dysfunction"],"prefix":"10.1177","volume":"55","author":[{"given":"Catherine","family":"de Blacam","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Our Lady\u2019s Children\u2019s Hospital, Crumlin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Orr","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Paediatrics, Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"bibr1-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1597\/03-148.1"},{"key":"bibr2-1055665617735102","first-page":"549","volume":"42","author":"Amir A","year":"1999","journal-title":"Ann Plast Surg"},{"key":"bibr3-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1994_031_0287_toaviw_2.3.co_2"},{"key":"bibr4-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181811a83"},{"key":"bibr5-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199402000-00007"},{"key":"bibr6-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000442"},{"key":"bibr7-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31822e624f"},{"key":"bibr8-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1597\/14-027"},{"key":"bibr9-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.9.4.252"},{"key":"bibr10-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199412000-00005"},{"key":"bibr11-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.3.216"},{"key":"bibr12-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198304000-00003"},{"key":"bibr13-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.01.020"},{"key":"bibr14-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(97)90047-8"},{"key":"bibr15-1055665617735102","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2014.00084"},{"key":"bibr16-1055665617735102","first-page":"569","volume-title":"Comprehensive Cleft Care","author":"D\u2019Antonio LL","year":"2009"},{"key":"bibr17-1055665617735102","first-page":"4","volume":"1195050","author":"Duband JL","year":"2016","journal-title":"Rare Dis"},{"key":"bibr18-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31825b3ba9"},{"key":"bibr19-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.11.006"},{"key":"bibr20-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31827c84f2"},{"key":"bibr21-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268e1b"},{"key":"bibr22-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198678060-00002"},{"key":"bibr23-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70135-X"},{"key":"bibr24-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1044\/jshd.3402.123"},{"key":"bibr25-1055665617735102","doi-asserted-by":"publisher","DOI":"10.1597\/11-211"},{"key":"bibr26-1055665617735102","unstructured":"Higgins A, Altman D, Sterne J. 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