{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:45:20Z","timestamp":1782287120315,"version":"3.54.5"},"reference-count":27,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/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":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>To delineate the indications, referral sources and outcomes of radical muscle dissection palate repair in the first 4 years of life for patients with submucous cleft palate (SMCP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>This study presents a retrospective analysis of a single surgeon's management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>All children were treated at Great Ormond Street Hospital, United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Twenty-three children with nonsyndromic SMCP were included in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>All participants underwent radical muscle dissection repair before their fourth birthday.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Parameters analyzed included: referral sources, indications for referral, extent of anatomical abnormality, and postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Paediatricians provided the largest proportion of referrals to the cleft lip and palate clinic (39%) due to the presence of cleft lip\/palate on prenatal scans or during neonatal examination. Over half (n\u2009=\u200912, 52%) of patients had severe anatomical anomalies being in grade IV (score 8-9), with the classical triad present to some extent in all but 2 of the patients. The main indication for surgery was nasal regurgitation of food and liquid (n\u2009=\u20099, 35%) followed by hypernasality (n\u2009=\u20096, 21%), difficulty feeding (n\u2009=\u20093, 8%), and severe anatomical defect (n\u2009=\u20092; 4%). Postoperatively, the presenting complaint improved in the majority of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Nonsyndromic SMCP is often missed, though may present with nasal regurgitation, feeding problems, and\/or hypernasality, though may be missed in nonsyndromic children. Early radical muscle dissection repair in the first 4 years of life is safe and effective, facilitating normal speech development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656221088170","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T04:02:53Z","timestamp":1647835373000},"page":"980-985","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Submucous Cleft Palate (SMCP): Indications and Outcomes of Radical Muscle Dissection Palatoplasty in Children Under 4 Years of Age"],"prefix":"10.1177","volume":"60","author":[{"given":"Ali M.","family":"Ghanem","sequence":"first","affiliation":[{"name":"Barts and the London School of Medicine and Dentistry, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samim","family":"Ghorbanian","sequence":"additional","affiliation":[{"name":"Barts and the London School of Medicine and Dentistry, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-4919","authenticated-orcid":false,"given":"Tiffanie-Marie","family":"Borg","sequence":"additional","affiliation":[{"name":"Barts and the London School of Medicine and Dentistry, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Sell","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Sommerlad","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"issue":"4","key":"bibr1-10556656221088170","first-page":"264","volume":"6","author":"Calnan J","year":"1954","journal-title":"Br J Plast 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