{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:38:46Z","timestamp":1782513526128,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"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":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess outcomes from cleft palate repair and define the level of impact of palatal fistula on subsequent velopharyngeal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>A regional specialist cleft lip and palate center within United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants:<\/jats:title>\n                    <jats:p>Nonsyndromic infants born between 2002 and 2009 undergoing cleft palate primary surgery by a single surgeon with audited outcomes at 5 years of age. Four hundred ten infants underwent cleft palate surgery within this period and 271 infants met the inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Cleft palate repair including levator palati muscle repositioning with or without lateral palatal release.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Postoperative fistula development and velopharyngeal function at 5 years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Lateral palatal incisions were required in 57% (156\/271) of all cases. The fistula rate was 10.3% (28\/271). Adequate palatal function with no significant velopharyngeal insufficiency (VPI) was achieved in 79% of patients (213\/271) after primary surgery only. Palatal fistula was significantly associated with subsequent VPI (risk ratio = 3.03, 95% confidence interval: 1.95-4.69; P &lt; .001). The rate of VPI increased from 18% to 54% when healing was complicated by fistula. Bilateral cleft lip and palate (BCLP) repair complicated by fistula had the highest incidence of VPI (71%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Cleft palate repair with levator muscle repositioning is an effective procedure with good outcomes. The prognostic impact of palatal fistula on subsequent velopharyngeal function is defined with a highly significant 3-fold increase in VPI. Early repair of palatal fistula should be considered, particularly for large fistula and in BCLP cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665619829388","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T07:47:01Z","timestamp":1550044021000},"page":"1008-1012","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Cleft Palate Outcomes and Prognostic Impact of Palatal Fistula on Subsequent Velopharyngeal Function\u2014A Retrospective Cohort Study"],"prefix":"10.1177","volume":"56","author":[{"given":"Alistair G.","family":"Smyth","sequence":"first","affiliation":[{"name":"Northern and Yorkshire Cleft Lip and Palate Service, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Dental Translational and Clinical Research Unit, School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"bibr1-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.01.031"},{"key":"bibr2-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1597\/13-121"},{"key":"bibr3-1055665619829388","volume-title":"Cleft Lip and\/or Palate","author":"Clinical Standards Advisory Group","year":"1998"},{"key":"bibr4-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000475829.32402.a8"},{"key":"bibr5-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.07.035"},{"key":"bibr6-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.05.019"},{"key":"bibr7-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1597\/04-141.1"},{"key":"bibr8-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.2012.169"},{"key":"bibr9-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24200"},{"key":"bibr10-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2009.10.018"},{"key":"bibr11-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182910acb"},{"key":"bibr12-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1597\/06-205.1"},{"key":"bibr13-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000085599.84458.D2"},{"key":"bibr14-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004324"},{"key":"bibr15-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182587b34"},{"key":"bibr16-1055665619829388","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000407"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665619829388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1055665619829388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665619829388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:19:52Z","timestamp":1777393192000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1055665619829388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,12]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1177\/1055665619829388"],"URL":"https:\/\/doi.org\/10.1177\/1055665619829388","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,12]]}}}