{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:41:04Z","timestamp":1793716864377,"version":"4.6.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R01DE028554"],"award-info":[{"award-number":["R01DE028554"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Objective<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>To evaluate different virtual-surgical interventions for the correction of unilateral cleft lip nasal deformity (uCLND)-induced nasal airway obstruction (NAO) using computational fluid dynamics (CFD) modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Design<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Preliminary pilot study involving virtual-surgical interventions based on pre-surgery computed tomography (CT) imaging with CFD analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Setting<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Patients, Participants<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Five subjects aged \u226515 years with uCLND who underwent preoperative CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Interventions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Virtual-surgical procedures involving varying combinations of inferior turbinate reduction (ITR), anterior (cartilaginous) septoplasty (AS), and posterior (osseous) septoplasty (PS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Main Outcome Measure(s)<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>CFD-identified greatest obstructive site, changes in nasal resistance and airflow distribution calculated from airflow simulations in preoperative and virtual-surgery nasal models, correlation of resistance changes with the minimal clinically important difference (MCID) for patient-reported Nasal Obstruction Symptom Evaluation (NOSE) scores, and evaluation of efficacious virtual procedures balancing surgical complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Results<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Preoperatively, all subjects had greater resistance on the cleft side. Isolated septoplasty reduced bilateral resistance by &lt;10%. Cleft-side ITR \u00b1 AS and\/or PS reduced bilateral resistance by 32% to 54%. Bilateral ITR \u00b1 AS\/PS achieved the largest improvements, with median reductions of 50% to 66% in bilateral resistance. Non-cleft ITR reduced resistance on the non-cleft side but often worsened airflow asymmetry. The number of procedures resulting in resistance improvements past the MCID threshold varied among subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>CFD-based virtual-surgical procedures indicated that ITR alone or with septoplasty provided the most effective improvement in nasal resistance and airflow for uCLND. Patient-specific anatomy strongly influenced efficacy, supporting the rationale for the use of computational modeling to assist in personalized surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261441755","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T08:14:57Z","timestamp":1780560897000},"page":"4085-4100","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Computationally Guided Simulation-Based Surgical Correction of Nasal Airway Obstruction in Patients With Cleft Lip Nasal Deformity"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-1186","authenticated-orcid":false,"given":"Elaine","family":"Lin","sequence":"first","affiliation":[{"name":"Duke University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan M.","family":"Sicard","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah L.","family":"Martin","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca E.","family":"Gosman","sequence":"additional","affiliation":[{"name":"Duke University"},{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reanna","family":"Shah","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Trotta","sequence":"additional","affiliation":[{"name":"BayCare Plastic and Reconstructive Surgery"},{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Marcus","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9683-8355","authenticated-orcid":false,"given":"Dennis O.","family":"Frank-Ito","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"Cleft palate","author":"Kosowski TR","unstructured":"Kosowski TR, Weathers WM, Wolfswinkel EM, Ridgway EB. 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