{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:48:47Z","timestamp":1791550127853,"version":"4.3.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"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":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Compare the incidence of palatal fistula and early postoperative maxillary morphology following cleft palate repair performed using the Lima protocol versus the Two-Flap technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a double-blind randomized controlled trial. Participants were randomly allocated to treatment groups using a random table. All surgeries were performed by a single surgeon at a single center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A national tertiary referral hospital, January 2022 to December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Infants aged 9 months to 2 years with unilateral cleft lip and palate who had not previously undergone palatal repair. Those with a history of prior palatal surgery or refusal to participate were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants underwent palatoplasty using either the Lima protocol (n\u2009=\u200916) or the Two-Flap technique (n\u2009=\u200919).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Incidence of palatal fistula and changes in early postoperative maxillary morphology during the first 6 months of follow-up, assessed using dental cast measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 39 patients were enrolled, with 35 completing follow-up. Baseline characteristics were comparable between groups. Postoperative palatal fistula occurred in 11% of patients, with no significant difference between the Lima and Two-Flap groups. Early postoperative maxillary morphology parameters showed similar trajectories across groups, except for greater inter-canine width in the Lima group at 6 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.017) and greater palatal length increase in the Two-Flap group between 1 and 6 months post-op (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both the Lima and Two-Flap techniques demonstrated comparable efficacy in preventing fistula and preserving early postoperative maxillary morphology. These findings represent short-term outcomes, and longer follow-up is required to evaluate long-term maxillary growth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261420473","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:14:31Z","timestamp":1770660871000},"page":"3628-3637","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["LIMA Protocol for Palatal Fistula Reduction and Early Postoperative Maxillary Morphology in Unilateral Cleft Lip and Palate: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6312-9261","authenticated-orcid":false,"given":"Kristaninta","family":"Bangun","sequence":"first","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberta Jesslyn","family":"Gunardi","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vika","family":"Tania","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasetyanugraheni","family":"Kreshanti","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieta","family":"Pancawati","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Division of Orthodontics, Department of Dentistry, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-3154","authenticated-orcid":false,"given":"Jessica","family":"Halim","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"},{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0403","authenticated-orcid":false,"given":"Clara","family":"Menna","sequence":"additional","affiliation":[{"name":"Cipto Mangunkusumo General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_472_20"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199705010-00010"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000407"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.14228\/jpr.v2i4.176"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.14228\/jpr.v1i2.49"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2019.08.012"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.14228\/jpr.v1i3.67"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.08.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1071-0949(06)80034-X"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001201"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006331"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1590\/1807-3107bor-2017.vol31.0046"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2008.05.048"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004324"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2019.00227"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000005775"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2018.06.017"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1996_033_0104_epcaip_2.3.co_2"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2009.04.038"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.2319\/071312-580.1"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoms.2025.05.004"},{"key":"e_1_3_3_23_2","volume-title":"Grabb and Smith\u2019s Plastic Surgery","author":"Thorne C","year":"2014","unstructured":"Thorne C, Chung K, Gosain A, Guntner GC, Mehrara BJ (eds) Grabb and Smith\u2019s Plastic Surgery. 7th ed. 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