Perscrutaziun actuala

This study compared speech intelligibility and perceived listening effort between children (aged 4-12) with syndromic and non-syndromic cleft palate, using 52 naive listeners. Children with syndromic clefts were significantly less intelligible and required substantially greater listening effort. The authors suggest that listening effort could serve as a complementary outcome measure and help flag previously undiagnosed syndromic cases.

This UK study describes the first development stage of the West Midlands Assessment of Speech-Preschool (WAS-P), a speech assessment designed specifically for 3-year-olds with cleft palate with or without cleft lip. Two age-appropriate speech samples were piloted with 20 children with clefts and 5 without. Both samples proved feasible and were judged suitable for routine clinical use, enabling standardised comparison of speech outcomes across cleft units.

This systematic review of 13 studies synthesized patient-reported psychosocial outcomes of velopharyngeal insufficiency (VPI) treatment after cleft palate repair, using the VELO and PedsQL instruments. Children with cleft-related VPI showed a substantial psychosocial burden before surgery, with evidence of improvement afterwards, particularly on VELO. However, longitudinal data were sparse and reporting inconsistent, so more standardised outcome reporting is needed.

This retrospective cohort study analyzed 676 patients with submucous cleft palate treated between 2008 and 2025. Palatal morphology correlated with velopharyngeal function, but younger age at surgery was the single most important predictor of achieving velopharyngeal competence, with the odds of an unfavourable outcome rising about 9% per additional year. Early diagnosis and timely intervention were the most critical factors for good speech outcomes.

This qualitative interview study explored how 16 adults born with cleft lip and/or palate experienced orthognathic (jaw-correcting) surgery. For many, surgery was a transformative process that went beyond functional and aesthetic correction, fostering greater self-confidence and social ease over time. However, empowerment was neither universal nor immediate, and some reported neutral or context-dependent outcomes.

Using data from 8045 children up to 36 months of age undergoing craniosynostosis surgery, the authors developed machine-learning models to predict perioperative blood transfusion risk and volume. The models achieved moderate predictive accuracy (AUC 0.77 for transfusion risk). Such tools could support individualized blood-product planning and selective use of cell salvage, but external validation is needed before clinical use.

This study compared perioperative outcomes for sagittal craniosynostosis (scaphocephaly) in children operated before 6 months versus after 7 months of age by the same surgeon. Younger patients had significantly shorter anaesthesia and surgery times and less blood loss and transfusion, while hospital stay did not differ. Early surgery before 6 months of age offered clear perioperative advantages.

Using serial measurements from 6694 infants treated with cranial-orthosis (helmet) therapy for deformational plagiocephaly and/or brachycephaly, the authors developed a machine-learning model to forecast head-shape changes during treatment. The model predicted final cranial asymmetry and cranial index with high accuracy. Such a tool could aid clinical decision-making and parental counselling, though further study is needed.

This 3D retrospective study assessed upper-airway changes after mandibular distraction osteogenesis and/or orthognathic surgery in 40 patients with hemifacial microsomia (16 children, 24 adults). Airway volume and cross-sectional area increased significantly after surgery in both groups, with reduced asymmetry. The findings suggest these procedures can improve upper-airway structure, supporting airway analysis in surgical planning.

This prospective study followed 30 patients with unilateral complete cleft lip and palate and moderate-to-severe midface deficiency treated with bone-anchored maxillary protraction (BAMP) for 18 months, with follow-up at least 5 years later. About 46% avoided orthognathic surgery, and results in this non-surgical subgroup remained stable long-term. A hyperdivergent growth pattern and more severe negative overjet predicted the eventual need for surgery.