{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:48:26Z","timestamp":1790718506087,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"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":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the long-term effect of timing of 1-stage palatoplasty on midfacial growth in patients with cleft lip and palate (CLP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting:<\/jats:title>\n                    <jats:p>Institutional hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>One hundred twelve patients with CLP who underwent palatoplasty and were divided into 3 groups: group I: operated between 9 and 11 months; group II: operated between 18 and 20 months; and group III: operated between 21 and 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>All patients underwent von Langenbeck palatoplasty technique, which was converted to a Bardach 2-flap technique in case of any technical difficulties. The patients were followed up between 8 and 9 years when they reported for secondary alveolar bone grafting. Postsurgical cephalometric and dental casts measurements were taken for midfacial growth analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>The cephalometric measures were analyzed for midfacial growth and compared within the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Statistically significant difference (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01) was found on comparing the cephalometric parameters such as sella\u2013nasion\u2013A point angle (SNA), A point\u2013nasion\u2013B point angle (ANB), n toperpendicular to point A (N-perpA), condylon to point A (Co-A), anterior nasal spine to posterior nasal spine (ANS-PNS), nasion to Anterior nasal spine (N-ANS), nasion to menton (N Me), and witts appraisal (Witt (AO-BO)) in group I when compared to both group II and group III patients, implying deficient midfacial growth in group I. No statistical difference was found in the cephalometric values between group II and group III. Group II had better cephalometric measurements than group III, showing better growth in group II than group III. Overall, there was less incidence of midfacial hypoplasia in patients treated between 18 and 20 months (group II).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We conclude that palatal closure carried out at 18 to 20 months and 21 to 24 months is associated with better midfacial growth when compared to closure at 9 to 11 months. The best time to operate would be between 18 and 20 months to avoid speech disturbances. Midfacial growth can be greatly influenced by the timing of 1-stage palatoplasty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656211013174","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T03:05:14Z","timestamp":1620529514000},"page":"239-245","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Does the Timing of 1-Stage Palatoplasty With Radical Muscle Dissection Effect Long-Term Midface Growth? A Single-Center Retrospective Analysis"],"prefix":"10.1177","volume":"59","author":[{"given":"Vikram","family":"Shetty","sequence":"first","affiliation":[{"name":"Nitte Meenakshi Institute of Craniofacial Surgery, NITTE Deemed to be University, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanda Kishore","family":"Patteta","sequence":"additional","affiliation":[{"name":"Department of Cleft and Craniofacial Orthodontics, NITTE Meenakshi Institute of Craniofacial Surgery, NITTE Deemed to be University, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-5151","authenticated-orcid":false,"given":"Anirudh","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial Institute of Dental Sciences, NITTE Deemed to be University, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devyani","family":"Bahl","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial Institute of Dental Sciences, NITTE Deemed to be University, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann F.","family":"Sailer","sequence":"additional","affiliation":[{"name":"Chairman, Klinik Professor Sailer, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjw046"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.4236\/ojst.2012.22023"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2009.11.003"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(1996)033<0051:IIOLAP>2.3.CO;2"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2002_039_0226_mttscp_2.0.co_2"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1597\/06-037.1"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2002_039_0425_cotmda_2.0.co_2"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(2000)037<0527:TIOSAO>2.0.CO;2"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000057971.87632.37"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d5132a"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijps.IJPS_84_18"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1990_027_0007_apsofg_2.3.co_2"},{"issue":"4","key":"e_1_3_2_14_1","first-page":"314","article-title":"The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate","volume":"24","author":"Mars M","year":"1987","unstructured":"Mars M, Plint DA, Houston WJ, Bergland O, Semb G. The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate. Cleft palate J. 1987;24(4):314\u2013322.","journal-title":"Cleft palate J"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/25.3.251"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01321795"},{"issue":"4","key":"e_1_3_2_17_1","first-page":"624","article-title":"Evaluation of craniofacial growth in patients with cleft lip and palate undergoing one-stage palate repair","volume":"26","author":"Pereira R","year":"2011","unstructured":"Pereira R, Melo E, Coutinho S, Vale D, Siqueira N, Alonso N. Evaluation of craniofacial growth in patients with cleft lip and palate undergoing one-stage palate repair. 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Cleft Palate J. 1987;24(1):5\u201377.","journal-title":"Cleft Palate J"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1054\/jcms.2001.0217"},{"issue":"5","key":"e_1_3_2_22_1","first-page":"810","article-title":"Midfacial morphology in adult unoperated complete unilateral cleft lip and palate patients","volume":"76","author":"Shetye PR","year":"2006","unstructured":"Shetye PR, Evans CA. Midfacial morphology in adult unoperated complete unilateral cleft lip and palate patients. 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