{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:21:00Z","timestamp":1791670860254,"version":"4.3.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2007,11,1]],"date-time":"2007-11-01T00:00:00Z","timestamp":1193875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2007,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Vague terminology is a problem in cleft palate research. No classification scheme for palatal fistulas has been proposed to date. Although a well-healed velum is a significant outcome of palatoplasty, it is nearly impossible to compare fistula-related palatoplasty results in the literature or in medical records without a standardized vocabulary. We endeavor to devise a palatal fistula classification system that may have clinical and research applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>PubMed was searched for definitions and classifications of palatal fistula as well as incidence and recurrence rates of this outcome. Next, a 25-year retrospective review of our Cleft Center's records was performed, and fistulas were identified (n = 641 charts reviewed). The fistula descriptions yielded by this chart review were evaluated in the context of anatomical descriptions in the literature, and a clinician-friendly classification scheme was designed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A literature review failed to reveal a standardized fistula classification system. An anatomically based numerical fistula classification system was devised: type I, bifid uvula; type II, soft palate; type III, junction of the soft and hard palate; type IV, hard palate; type V, junction of the primary and secondary palates (for Veau IV clefts); type VI, lingual alveolar; and type VII, labial alveolar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We propose a standardized numerical classification system for palatal fistulas. Its clinical adoption may prospectively clarify ambiguities in the literature and facilitate future cleft palate research and clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1597\/06-204.1","type":"journal-article","created":{"date-parts":[[2007,11,9]],"date-time":"2007-11-09T15:03:50Z","timestamp":1194620630000},"page":"590-594","source":"Crossref","is-referenced-by-count":289,"title":["The Pittsburgh Fistula Classification System: A Standardized Scheme for the Description of Palatal Fistulas"],"prefix":"10.1177","volume":"44","author":[{"given":"Darren M.","family":"Smith","sequence":"first","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Vecchione","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Ford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic W. B.","family":"Deleyiannis","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Ann Haralam","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Naran","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine I.","family":"Worrall","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R.","family":"Dudas","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Afifi","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L.","family":"Marazita","sequence":"additional","affiliation":[{"name":"Center for Craniofacial and Dental Genetics and Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Losee","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, Division of Pediatric Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2007,11,1]]},"reference":[{"key":"bibr1-06-204.1","doi-asserted-by":"publisher","DOI":"10.3109\/02844317909013073"},{"key":"bibr2-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(88)90044-4"},{"key":"bibr3-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199304001-00008"},{"key":"bibr4-06-204.1","author":"Baker S.B.","year":"1999","journal-title":"Plastic Surgical Forum."},{"key":"bibr5-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198403000-00004"},{"key":"bibr6-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(90)90089-I"},{"key":"bibr7-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197810000-00006"},{"key":"bibr8-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199211000-00004"},{"key":"bibr9-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(89)80093-9"},{"key":"bibr10-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199106000-00005"},{"key":"bibr11-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-200607000-00005"},{"key":"bibr12-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000148650.32055.01"},{"key":"bibr13-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199705010-00010"},{"key":"bibr14-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)31050-6"},{"key":"bibr15-06-204.1","doi-asserted-by":"publisher","DOI":"10.1080\/02844310310004424"},{"key":"bibr16-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196608000-00007"},{"key":"bibr17-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(88)90045-6"},{"key":"bibr18-06-204.1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2000_037_0127_copfwa_2.3.co_2"},{"key":"bibr19-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198704000-00001"},{"key":"bibr20-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000239612.35581.c3"},{"key":"bibr21-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000191173.14154.ef"},{"key":"bibr22-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198706000-00006"},{"key":"bibr23-06-204.1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989411100115"},{"key":"bibr24-06-204.1","first-page":"156","volume":"25","author":"Moore M.D.","year":"1988","journal-title":"Cleft Palate J."},{"key":"bibr25-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200111000-00011"},{"key":"bibr26-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-199711000-00013"},{"key":"bibr27-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199303000-00007"},{"key":"bibr28-06-204.1","first-page":"490","volume-title":"Cleft Lip and Palate.","author":"Oneal R.M.","year":"1971"},{"key":"bibr29-06-204.1","doi-asserted-by":"publisher","DOI":"10.3109\/02844318009106716"},{"key":"bibr30-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(89)80038-1"},{"key":"bibr31-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198678060-00004"},{"key":"bibr32-06-204.1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890100017003"},{"key":"bibr33-06-204.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(89)80039-3"},{"key":"bibr34-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000185469.80256.9e"},{"key":"bibr35-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-199509000-00008"},{"key":"bibr36-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200102000-00002"},{"key":"bibr37-06-204.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199712000-00046"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1597\/06-204.1","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1597\/06-204.1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:20:36Z","timestamp":1777393236000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1597\/06-204.1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,11]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2007,11]]}},"alternative-id":["10.1597\/06-204.1"],"URL":"https:\/\/doi.org\/10.1597\/06-204.1","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,11]]}}}