{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:16Z","timestamp":1788667876022,"version":"build-2803163510"},"reference-count":55,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"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>To compare aesthetic outcomes in patients with bilateral cleft lip treated with concurrent primary rhinoplasty (PR) versus non-primary rhinoplasty (NPR), using layperson and anthropometric assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective review of patients undergoing bilateral cleft lip repair between 2008 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary care institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants<\/jats:title>\n                    <jats:p>Seventy-five children (mean age = 6.1\u2009\u00b1\u20093.6 months) who underwent bilateral cleft lip repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>PR performed in 55 patients (73.3%) and non-PR in 20 patients (26.7%). Preoperative cleft severity was graded with the Bilateral Cleft Lip Severity Index (BCLSI; grades 1-3). Presurgical nasoalveolar molding (NAM) and nasal stenting were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Layperson perception surveys (pairwise comparison and Likert scale) and anthropometric analyses of nasal appearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lower BCLSI scores predicted superior aesthetic ratings. Lip adhesion after NAM failure correlated with inferior ratings (\n                      <jats:italic toggle=\"yes\">p\u2009&lt;\u2009.<\/jats:italic>\n                      001). Overall, PR did not yield superior nasal appearance compared with NPR. In subgroup analysis, PR patients in the BCLSI3 group had higher layperson scores (\n                      <jats:italic toggle=\"yes\">p\u2009=\u2009.<\/jats:italic>\n                      036). PR with nasal stenting \u226521 days was associated with greater Goode's ratio (\n                      <jats:italic toggle=\"yes\">p\u2009&lt;\u2009.<\/jats:italic>\n                      001). Increased columellar-labial angle correlated with inferior nasal appearance (\n                      <jats:italic toggle=\"yes\">p\u2009=\u2009.<\/jats:italic>\n                      029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data highlight the impact of presurgical NAM on oronasal outcomes and preoperative cleft severity to guide personalized surgical approaches in this patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251415231","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:34:41Z","timestamp":1775741681000},"page":"3398-3407","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Cleft Lip Repair With and Without Primary Rhinoplasty: Comparing Two-Year Aesthetic and Anthropometric Outcomes"],"prefix":"10.1177","volume":"63","author":[{"given":"Allison C","family":"Hu","sequence":"first","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H","family":"Sussman","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip D","family":"Tolley","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A","family":"Han","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel A","family":"Ryan","sequence":"additional","affiliation":[{"name":"Children's Hospital of 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