{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:16Z","timestamp":1789020436521,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"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":["Plast Surg (Oakv)"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgical repair of large cleft palates is challenging and is associated with high postoperative fistula rates. Midline tension is a critical factor in fistula formation. Foraminotomy enables increased medial mobilization of the palatal flaps, particularly in cases in which standard palatal closure would otherwise result in excessive midline tension; however, this procedure carries a risk of neurovascular pedicle injury and subsequent flap necrosis. In this study, we present our surgical technique for piezoelectric palatine foraminotomy to facilitate palatal flap mobilization and tension-free closure in large cleft palate repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventeen patients with wide cleft palates (\u226515 mm cleft width; Veau class II-IV) who underwent primary palatoplasty with piezoelectric foraminotomy between 2017 and 2020 were reviewed. All procedures were performed by a single senior surgeon. The piezoelectric device equipped with a sinus lift tip was used to enlarge the palatine canal via controlled removal of the posteromedial bony wall, allowing tension-free medial mobilization of the neurovascular pedicle. Postoperative outcomes including fistula formation, flap necrosis, and neurovascular complications were assessed over a minimum 12-month follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No intraoperative or postoperative neurovascular pedicle injury, flap necrosis, or wound infection was observed. Oronasal fistula developed in 3 patients (17.6%), all with Veau class III or IV clefts, located at the hard palate-soft palate junction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Piezoelectric osteotomy for palatine foraminotomy is a feasible, controlled, and soft tissue-preserving technique that may enhance the safety of neurovascular pedicle mobilization in wide cleft palate repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22925503261477397","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:35:37Z","timestamp":1789018537000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Piezoelectric Palatine Foraminotomy in Wide Cleft Palate Repair: A New Approach for Safe Neurovascular Pedicle Mobilization"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1650-5957","authenticated-orcid":false,"given":"\u00d6mer","family":"Koka\u00e7ya","sequence":"first","affiliation":[{"name":"\u00c7ukurova University Faculty of Medicine, Balcal\u0131 Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1031-1868","authenticated-orcid":false,"given":"\u0130brahim","family":"Tabakan","sequence":"additional","affiliation":[{"name":"\u00c7ukurova University Faculty of Medicine, Balcal\u0131 Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6970-5724","authenticated-orcid":false,"given":"Abdullah","family":"Arslan","sequence":"additional","affiliation":[{"name":"\u00c7ukurova University Faculty of Medicine, Balcal\u0131 Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gazi Kutalm\u0131\u015f","family":"Yaprak","sequence":"additional","affiliation":[{"name":"\u00c7ukurova University Faculty of Medicine, Balcal\u0131 Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8914-9933","authenticated-orcid":false,"given":"Ali","family":"Kuru","sequence":"additional","affiliation":[{"name":"\u00c7ukurova University Faculty of Medicine, Balcal\u0131 Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000548"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.05.019"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31823aea7e"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2012.12.003"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000205176.90736.e4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200111000-00011"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199705010-00010"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199106000-00005"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2003_040_0280_ifrfpi_2.0.co_2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000010047"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000012422"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000407"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318199669b"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000000967"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000637"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1597\/14-127"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1017\/s0022215100091313"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200103000-00026"},{"issue":"5","key":"e_1_3_2_20_2","first-page":"207","article-title":"Technological characteristics and clinical indications of piezoelectric bone surgery","volume":"53","author":"Vercellotti T","year":"2004","unstructured":"Vercellotti T. 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