{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:35:48Z","timestamp":1777523748516,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"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":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if preoperative velopharyngeal closure percentage (VCP) is predictive of successful Furlow double opposing Z-plasty (DOZP) and subsequently determine the optimal velopharyngeal closure cutoff for successful DOZP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic center<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>110 patients with repaired cleft lip and palate having hypernasality treated with DOZP<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Speech videofluoroscopy images were used to obtain the preoperative VCP and other measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Changes in hypernasality scores using the Cleft Audit Protocol for Speech-Augmented-Americleft Modification (CAPS-A-AM) rating system were used as the primary outcome measure. A successful DOZP was defined as a postoperative hypernasality score of\u2009\u2264\u20091 or an improvement of 2 or more scores from baseline. A receiver operating characteristic (ROC) curve was calculated to determine preoperative VCP cutoff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 110 patients who underwent DOZP for treatment of velopharyngeal insufficiency. Of these patients, 94 (85%) had successful surgery as determined by their postoperative CAPS-A-AM hypernasality score. Preoperative VCP was a statistically significant predictor of successful DOZP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). The ROC curve with Youden index (J) determined a cutoff (c*) of 55% preoperative VCP or greater to optimize surgical success rate. Grouping by preoperative VCP showed that surgical success increases directly with preoperative VCP, and patients with low VCP had above a 50% success rate in reducing hypernasality scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative VCP was significantly associated with improved hypernasality ratings postoperatively. A preoperative VCP of \u226555% may be used to help predict success of Furlow palatoplasty treatment. Patients with lower VCP can still benefit from secondary DOZP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241237422","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T12:43:56Z","timestamp":1710420236000},"page":"1023-1031","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Preoperative Velopharyngeal Closure Predicts Hypernasality Outcomes of Secondary Furlow Double-Opposing Z-Plasty"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-9124","authenticated-orcid":false,"given":"Kayla","family":"Prezelski","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Health, Dallas, Texas, USA"},{"name":"Children's Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7355-7107","authenticated-orcid":false,"given":"Carolyn","family":"Kim","sequence":"additional","affiliation":[{"name":"Analytical Imaging and Modeling Center, Children\u2019s Health, Dallas, Texas, USA"},{"name":"Children's Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeyna","family":"Perez","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Health, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cortney","family":"Vant Slot","sequence":"additional","affiliation":[{"name":"Children's Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex A.","family":"Kane","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Health, Dallas, Texas, USA"},{"name":"Children's Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Seaward","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Health, Dallas, Texas, USA"},{"name":"Children's Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"issue":"11","key":"e_1_3_3_2_2","first-page":"688","article-title":"Frequency of pharyngoplasty after primary repair of cleft palate","volume":"68","author":"Bicknell S","year":"2002","unstructured":"Bicknell S, McFadden LR, Curran JB. 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