{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:17:11Z","timestamp":1787836631357,"version":"build-2784847793"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study is to characterize the clinical features, associated anomalies, and surgical outcomes of patients with midline cleft lip (MCL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary craniofacial referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>Pediatric patients evaluated by the Plastic and Maxillofacial Surgery Division for repair of MCL between 2004 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Surgical repair of MCL using wedge excision, straight-line closure\u2009\u00b1\u2009triangular flaps, and\/or release of aberrant orbicularis oris attachments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Surgical safety, postoperative complications, revision rate, and improvement in midline facial symmetry quantified by horizontal deviation of key landmarks from the facial midline using ImageJ software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty patients were included; 60% had cleft lip and palate, and 40% had isolated cleft lip. Central nervous system anomalies were present in 65% of patients. One patient expired preoperatively. Median age at repair was 6.4 months, with a mean follow-up of 10.4 years. Surgical techniques included wedge excision, straight-line closure\u2009\u00b1\u2009triangular flaps, and release of aberrant orbicularis oris attachments. No intraoperative complications occurred; two patients had major postoperative complications. Revisions were performed in 20% of patients. Image analysis showed a mean reduction in midline deviation for subnasale, labiale superius, and left crista philtri, indicating significantly improved symmetry for these landmarks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MCL is a rare anomaly often associated with central nervous system comorbidities. Repair was safe and resulted in improved midline symmetry confirmed by image analysis. The 20% revision rate highlights the need for continued refinement of surgical techniques and long-term management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261481249","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:14:07Z","timestamp":1787674447000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Two Decades of Midline Cleft Lip Management: Insights from a Single Institution on a Rare Anomaly"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0088-2991","authenticated-orcid":false,"given":"Artur","family":"Manasyan","sequence":"first","affiliation":[{"name":"Children's"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7220-8102","authenticated-orcid":false,"given":"Raina K","family":"Patel","sequence":"additional","affiliation":[{"name":"Children's"},{"name":"Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Kim","sequence":"additional","affiliation":[{"name":"Children's"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryem","family":"Guler","sequence":"additional","affiliation":[{"name":"Children's"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0594-7661","authenticated-orcid":false,"given":"Caroline","family":"Kreh","sequence":"additional","affiliation":[{"name":"Children's"},{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, 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