{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:10Z","timestamp":1788667870517,"version":"build-2803163510"},"reference-count":25,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"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":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Investigate the pre- and postoperative changes in patients with submucous cleft palate (SMCP) treated by intravelar veloplasty (IVV) with a buccinator musculomucosal flap (BMMF).<\/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>Tertiary, cleft team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants<\/jats:title>\n                    <jats:p>Children with SMCP who underwent IVV with a BMMF at Nagano Children's Hospital.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Interventions:<\/jats:bold>\n                      IVV with a BMMF between December 2018 and January 2022.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Perceptual Japanese speech evaluation (hypernasality [HN], nasal emission, and intelligibility [IN]), amount of velopharyngeal (VP) gap, degree of soft palate elevation, amount of soft palate lengthening, VP closure pattern, additional surgery, and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven patients (four syndromic) were analyzed pre- and almost of 1 year postoperatively. Preoperative mean HN and IN scores were significantly improved (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0232 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0313, respectively). VP gap was closed after surgery in most cases with initial VP gap &lt;4.5\u2005mm and good soft palate elevation. Mean soft palate lengthening with the BMMF method was 3.9\u2009\u00b1\u20091.2\u2005mm, which was a significant increase (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.00589). Four patients required additional surgery. We encountered no severe postoperative complications or fistula formation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IVV with a BMMF is considered applicable in patients with VP gap of up to 4.0 to 4.5\u2005mm and good soft palate elevation. Our technique appears safe, with low risks of severe postoperative complications and fistula formation. Due to the limited cohort size, more cases are needed to elucidate the precise indications for the BMMF method.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251409643","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T17:14:02Z","timestamp":1767028442000},"page":"3280-3290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Outcomes of Submucous Cleft Palate Using Intravelar Veloplasty with a Buccinator Musculomucosal Flap: A Case Series"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9993-8784","authenticated-orcid":false,"given":"Kiichiro","family":"Yaguchi","sequence":"first","affiliation":[{"name":"Shinshu University School of Medicine"},{"name":"Nagano Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-5354","authenticated-orcid":false,"given":"Masahiko","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Nagano Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8573-558X","authenticated-orcid":false,"given":"Fumio","family":"Nagai","sequence":"additional","affiliation":[{"name":"Shinshu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Nagano Matsushiro General Hospital, Nagano, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4349-7511","authenticated-orcid":false,"given":"Masato","family":"Akimoto","sequence":"additional","affiliation":[{"name":"Nagano Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8391-0952","authenticated-orcid":false,"given":"Kazuhiro","family":"Tsunekawa","sequence":"additional","affiliation":[{"name":"Shinshu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2218-9601","authenticated-orcid":false,"given":"Shunsuke","family":"Yuzuriha","sequence":"additional","affiliation":[{"name":"Shinshu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0007-1226(53)80060-3"},{"key":"e_1_3_2_3_2","first-page":"356","article-title":"The occult submucous cleft palate","volume":"12","author":"Kaplan EN","unstructured":"Kaplan EN. 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