{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:24:00Z","timestamp":1777523040852,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,4,26]],"date-time":"2018-04-26T00:00:00Z","timestamp":1524700800000},"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":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and\/or cleft palate (CL\/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Cleft Lip and Palate Program, Children\u2019s Hospital of Philadelphia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Subjects:<\/jats:title>\n                    <jats:p>One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL\/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Nasal Obstruction Symptom Evaluation surveys completed at each annual visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Composite NOSE and individual symptom scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms ( P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes ( P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery ( P = .006). There was no significant difference ( P &gt; .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665618772400","type":"journal-article","created":{"date-parts":[[2018,4,26]],"date-time":"2018-04-26T12:14:30Z","timestamp":1524744870000},"page":"177-186","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Nasal Obstruction in Children With Cleft Lip and Palate: Results of a Cross-Sectional Study Utilizing the NOSE Scale"],"prefix":"10.1177","volume":"56","author":[{"given":"Rosaline S.","family":"Zhang","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence O.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian C.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oksana A.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Low","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott P.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan W.","family":"Swanson","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,4,26]]},"reference":[{"key":"bibr1-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31825dc10a"},{"key":"bibr2-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318199f46e"},{"key":"bibr3-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198303000-00007"},{"key":"bibr4-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2014.01.031"},{"key":"bibr5-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.03.044"},{"key":"bibr6-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043405"},{"key":"bibr7-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2000_037_0538_sclnrs_2.0.co_2"},{"key":"bibr8-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(99)00006-3"},{"key":"bibr9-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-33062"},{"key":"bibr10-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2014.01.002"},{"key":"bibr11-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000027"},{"key":"bibr12-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2009.02.023"},{"key":"bibr13-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318200a97a"},{"key":"bibr14-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(03)00140-8"},{"key":"bibr140-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2005.02.074"},{"key":"bibr15-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000066"},{"issue":"4","key":"bibr16-1055665618772400","first-page":"1","volume":"121","author":"Guyuron B","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"bibr17-1055665618772400","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182402e8e"},{"key":"bibr18-1055665618772400","unstructured":"International Consortion for Health Outcomes Measurement (ICHOM). 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