{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:38:53Z","timestamp":1777523933420,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"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":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Autologous fat graft injection to the soft palate is a relatively new treatment for velopharyngeal insufficiency (VPI). This study aimed at evaluating the outcome following fat injection into soft palate and speech therapy in selected patients to determine the good candidates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Institutional tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>The study included 22 patients with VPI associated with repaired cleft palate (CP), submucous cleft, or post-adenoidectomy. The inclusion criteria were mild to moderate hypernasality and velopharyngeal closure\u2009&gt;\u200950%. Patients with severe hypernasality, intelligibility grade 4, closure\u2009&lt;\u200950%, syndromic CP, intellectual disability, and hearing impairment were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Autologous fat was injected into the velum trans-orally under endoscopic guidance followed by speech therapy. Motor-phonetic and biofeedback therapies were carried out 3 sessions weekly for 3 months to treat misarticulations and residual hypernasality. Speech scores were assessed preoperative and post-therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Main Outcome Measures<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Scores of hypernasality, nasal emission, speech intelligibility, and velopharyngeal closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The hypernasality, nasal emission, speech intelligibility, and VP closure scores significantly improved following fat injection and speech therapy (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\u2009.001, .008, .004, and .015 respectively). The predictive factors of better outcome were young age, post-adenoidectomy, small gap, transverse palatal muscles, and coronal closure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.02, .005, .004, .001, and .002 respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fat injection into the soft palate followed by speech therapy is a safe and successful treatment for mild to moderate VPI and best selected for patients with transverse palatal muscles, young children, and small gaps. Further studies with a greater number of subjects are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241304216","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T03:22:31Z","timestamp":1748920951000},"page":"529-538","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Speech Outcome Following Autologous Fat Grafting in Soft Palate for Velopharyngeal Insufficiency"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8225-2436","authenticated-orcid":false,"given":"Megahed M.","family":"Hassan","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Elsayed","family":"Gelaney","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona El-Rabie","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Abdel-Aal","family":"Hassanyn","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif","family":"Bakry","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-1529","authenticated-orcid":false,"given":"Ahmed","family":"Elsherbiny","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1234044"},{"key":"e_1_3_3_3_2","unstructured":"Kummer AW. Cleft palate & craniofacial anomalies: Effects on speech and resonance 2013 Nelson Education."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110846"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110847"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2002_039_0295_prrr_2.0.co_2"},{"key":"e_1_3_3_7_2","first-page":"67","article-title":"Furlow double-opposing z-plasty","volume":"76","author":"Furlow: Raol N","year":"2015","unstructured":"Furlow: Raol N, Hartnick CJ. Furlow double-opposing z-plasty. Adv Otorhinolaryngol. 2015;76:67\u201373. doi: https:\/\/doi.org\/10.1159\/000368022. Epub 2015 Feb 19. PMID: 25733234.","journal-title":"Adv Otorhinolaryngol"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004612"},{"key":"e_1_3_3_9_2","first-page":"50","article-title":"Superiorly based pharyngeal flap","volume":"76","author":"Pharyngeal flap: Raol N","year":"2015","unstructured":"Pharyngeal flap: Raol N, Hartnick CJ. Superiorly based pharyngeal flap. Adv Otorhinolaryngol. 2015;76:50\u201357. doi: https:\/\/doi.org\/10.1159\/000368016. Epub 2015 Feb 19. PMID: 25733232.","journal-title":"Adv Otorhinolaryngol"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.3.864"},{"key":"e_1_3_3_11_2","article-title":"Suspension palatoplasty\u2019 - A new method of primary palate repair for speaking un-repaired clefts","author":"Damalachervu MR","year":"2023","unstructured":"Damalachervu MR, Yellinedi R, Nuvvula R. Suspension palatoplasty\u2019 - A new method of primary palate repair for speaking un-repaired clefts. Cleft Palate Craniofac J. 2023:62(3):423-429.10556656231207554. doi: https:\/\/doi.org\/10.1177\/10556656231207554","journal-title":"Cleft Palate Craniofac J"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003702"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijps.IJPS_183_17"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.1920"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419882063"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199003000-00011"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26227"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27853"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665617739002"},{"issue":"1","key":"e_1_3_3_20_2","article-title":"Aberrant extracranial internal carotid arteries: New insights, implications, and demand for a clinical grading system","volume":"38","author":"Pfeiffer J","year":"2016","unstructured":"Pfeiffer J, Becker C, Ridder GJ. Aberrant extracranial internal carotid arteries: New insights, implications, and demand for a clinical grading system. Head Neck J. 2016;38(S1):E687\u2013E693. doi:https:\/\/doi.org\/10.1002\/hed.24071","journal-title":"Head Neck J"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2014.02.001"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.82749"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2011.25.5.358"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.61.8.1151"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.80.11.1026"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31824db85b"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.09.021"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.08.001"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200112000-00015"},{"issue":"4","key":"e_1_3_3_30_2","article-title":"Effectiveness and safety of autologous fat grafting to the soft palate alone","volume":"74","author":"Boneti C","year":"2015","unstructured":"Boneti C, Ray PD, Macklem EB, Kohanzadeh S, de la Torre J, Grant JH. Effectiveness and safety of autologous fat grafting to the soft palate alone. Annals Plastic Surg. 2015;74(4):S190\u2013S192. doi:https:\/\/doi.org\/10.1097\/SAP.0000000000000442","journal-title":"Annals Plastic Surg"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2023.01.003"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.7123\/01.EJO.0000429577.63818.de"},{"key":"e_1_3_3_33_2","first-page":"321","article-title":"Ein mass fur die nasalitat","volume":"7","author":"Gutzman H","year":"1922","unstructured":"Gutzman H. Ein mass fur die nasalitat. Arch Neen Physiol. 1922;7:321.","journal-title":"Arch Neen Physiol"},{"key":"e_1_3_3_34_2","unstructured":"Czermark JN Gasamelet schriften. Vienna. In: Luchsinger R Arnold GE eds. Voice speech and language. London: constable. 1965;1:668."},{"key":"e_1_3_3_35_2","unstructured":"Harding A Harland K Razzell RE. Cleft Audit Protocol for Speech: CAPS. 1996. Available from St. Andrew's Centre for Plastic Surgery Broomfield Hospital Essex CM1 7ET England."},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1597\/04-141.1"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1990_027_0337_sftron_2.3.co_2"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619900621"},{"issue":"96","key":"e_1_3_3_39_2","first-page":"27","article-title":"Patterns and grade of velopharyngeal closure in candidates for adenotonsillectomy","volume":"30","author":"El-Anwar MW","unstructured":"El-Anwar MW, El-Sheikh E, El-Nakeb N. Patterns and grade of velopharyngeal closure in candidates for adenotonsillectomy. Iran J Otorhinolaryngol. 2018 Jan;30(96):27\u201331.","journal-title":"Iran J Otorhinolaryngol"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.109849"},{"key":"e_1_3_3_41_2","first-page":"401","volume-title":"Cleft palate and craniofacial anomalies","author":"Kummer AW","year":"2005","unstructured":"Kummer AW. The effects on speech and resonance. In: Cleft palate and craniofacial anomalies. WB Saunders; 2005:401\u2013424."},{"key":"e_1_3_3_42_2","volume-title":"Cleft palate and craniofacial anomalies","author":"Kummer AW","unstructured":"Kummer AW. The effects on speech and resonance. In: Cleft palate and craniofacial anomalies. Cengage Learning; 2014; 270-340."},{"key":"e_1_3_3_43_2","volume-title":"Communicative disorders related to cleft lip and palate","author":"Bzoch KR","year":"2004","unstructured":"Bzoch KR. Communicative disorders related to cleft lip and palate. Pro-Ed; 2004."},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348940101000406"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1597\/02-102"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656241304216","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656241304216","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656241304216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:22:14Z","timestamp":1777393334000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656241304216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/10556656241304216"],"URL":"https:\/\/doi.org\/10.1177\/10556656241304216","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]}}}