{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:06:29Z","timestamp":1778976389852,"version":"3.51.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"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":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the workflow of cleft teams in the Netherlands with regard to the diagnosis and treatment of velopharyngeal insufficiency (VPI) in patients with cleft palate (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a cross-sectional survey study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multicenter study, tertiary hospital setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Ear-nose-throat surgeons, plastic surgeons and speech language pathologists of the eight cleft teams in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>A cross-sectional online survey was sent to the participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>The survey questions covered the following topics: diagnostic tests used to assess VPI, use of classification systems and cut-off values to determine the most optimal treatment, treatment of VPI, and postoperative follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The response rate was 88% (n\u2009=\u20097 cleft teams). Frequently described diagnostic tests to assess VPI include perceptual speech assessment, mirror test, nasendoscopy, oral inspection, patient-reported outcome measures, nasometry, and videofluoroscopy. Most centers reported that they did not use a classification system to determine the severity of VPI. None of the centers reported to use cut-off values based on the diagnostic tests to determine optimal treatment. The reported minimum duration of speech therapy prior to surgery varied. Many different surgical techniques were reported for the treatment of VPI. Regarding postoperative follow-up, survey responses indicate agreement on the multidisciplinary approach and diagnostic tests used. The timing of the visits varied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Further standardization of the diagnostic process and treatment workflow of VPI in patients with CP between Dutch cleft centers is needed in order to compare outcomes of different surgical techniques and to establish a national protocol for optimal treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251341757","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T18:37:35Z","timestamp":1747679855000},"page":"1553-1561","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dutch Workflow for Diagnosis and Treatment of Velopharyngeal Insufficiency in Patients with Cleft Palate\u2014A Survey Study"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7173-4713","authenticated-orcid":false,"given":"JJ","family":"Peters","sequence":"first","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"},{"name":"Amsterdam Reproduction and Development research institute, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8324-3028","authenticated-orcid":false,"given":"SA","family":"van der Kooij","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1260-7248","authenticated-orcid":false,"given":"CDL","family":"van Gogh","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8118-3061","authenticated-orcid":false,"given":"MJ","family":"Coerts","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4591-651X","authenticated-orcid":false,"given":"JPW","family":"Don Griot","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8479-4850","authenticated-orcid":false,"given":"CM","family":"Moues-Vink","sequence":"additional","affiliation":[{"name":"Leeuwarden Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-0881","authenticated-orcid":false,"given":"T","family":"Wagner","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3730-2075","authenticated-orcid":false,"given":"RM","family":"Schols","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"van Nimmen","sequence":"additional","affiliation":[{"name":"Elisabeth-TweeSteden Ziekenhuis (ETZ)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3201-1372","authenticated-orcid":false,"given":"MM","family":"Pleumeekers","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center, Rotterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1649-6824","authenticated-orcid":false,"given":"M","family":"Ruettermann","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EC","family":"Paes","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-4785","authenticated-orcid":false,"given":"TR","family":"De Jong","sequence":"additional","affiliation":[{"name":"Isala Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3587-7489","authenticated-orcid":false,"given":"CC","family":"Breugem","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam"},{"name":"Amsterdam Reproduction and Development research institute, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1597\/15-221"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221149144"},{"key":"e_1_3_3_4_2","unstructured":"Dutch Association for Cleft Palate and Craniofacial Anomalies. 2020. Annual report - Orofacial cleft registration the Netherlands."},{"key":"e_1_3_3_5_2","unstructured":"Dutch Association for Cleft Palate and Craniofacial Anomalies. 2021. Annual report - Orofacial cleft registration the Netherlands."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000171"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000900"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.egja.2018.05.003"},{"key":"e_1_3_3_9_2","volume-title":"StatPearls [Internet]","author":"Young A","year":"2024","unstructured":"Young A, Spinner A. Velopharyngeal Insufficiency. In: StatPearls [Internet]. StatPearls Publishing; 2024. PMID: 33085296."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1277712"},{"issue":"4","key":"e_1_3_3_11_2","first-page":"369","article-title":"Patterns of velopharyngeal closure in subjects with repaired cleft palate and normal speech: A multi-view videofluoroscopic analysis","volume":"12","author":"Skolnick ML","year":"1975","unstructured":"Skolnick ML, Shprintzen RJ, McCall GN, Rakoff S. Patterns of velopharyngeal closure in subjects with repaired cleft palate and normal speech: A multi-view videofluoroscopic analysis. Cleft Palate J. 1975;12(4):369\u2013376.","journal-title":"Cleft Palate J"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009555"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003335"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1597\/05-001.1"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-319123"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620954063"},{"key":"e_1_3_3_17_2","unstructured":"care Dgcp. https:\/\/richtlijnendatabase.nl\/richtlijn\/behandeling_van_patienten_met_een_schisis\/hypernasaliteit_bij_patienten_met_een_schisis\/diagnostiek_van_hypernasaliteit_bij_schisis.html."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1277718"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2003\/056)"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2014.05.004"},{"key":"e_1_3_3_21_2","unstructured":"von Elm EAD Egger M Pocock SJ Gotzsche PC Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies."},{"issue":"3","key":"e_1_3_3_22_2","doi-asserted-by":"crossref","DOI":"10.1097\/SAP.0000000000003198","article-title":"Revision pharyngoplasty in cleft palate and velopharyngeal insufficiency: Management and outcomes","volume":"88","author":"Bruce MK","year":"2022","unstructured":"Bruce MK, Zhang C, Vodovotz L, Irgebay Z, Maliha S, Pfaff M, Ford M, Goldstein JA, Losee JE. Revision pharyngoplasty in cleft palate and velopharyngeal insufficiency: Management and outcomes. Ann Plast Surg. 2022;88(3 Suppl 3):S152\u2013s155. doi:https:\/\/doi.org\/10.1097\/sap.0000000000003198","journal-title":"Ann Plast Surg"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29189"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2021.09.017"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007938"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211053761"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699206.2021.1983021"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1159\/000517296"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2020.07.016"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665621990174"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211001732"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000005337"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006300"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618756072"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004769"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1597\/14-027"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2010.0660"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221141188"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665617718549"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1597\/13-107"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1044\/2015_JSLHR-S-14-0236"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620954749"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110820"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(03)00098-3"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665617735102"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.01.020"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003971"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004078"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251341757","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656251341757","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251341757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T23:16:13Z","timestamp":1778973373000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656251341757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":47,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/10556656251341757"],"URL":"https:\/\/doi.org\/10.1177\/10556656251341757","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]}}}