Tessier Craniofacial Clefts.

Craniofacial clefts are extremely rare. In 1976, Paul Tessier developed a comprehensive numerical classification system to categorize craniofacial clefts based on precise anatomic location. In order to comprehend craniofacial cleft development, it is crucial to understand embryologic development of the face.

Analysis of Health Determinants in Cleft Palate Patients.

Objective: This study aims to analyze health determinants affecting patients with cleft palate, specifically examining the relationships between the Social Vulnerability Index (SVI), failure to thrive (FTT), and healthcare utilization within the initial 30 days and first year of life.

Methods: A retrospective analysis was conducted on patients with a cleft palate at a tertiary care center over an 11-year period. Data included demographics, weight percentile trends, pediatric emergency department (PED) visits, hospital admissions, SVI scores, cleft palate type, and FTT diagnoses.

Frontal Sinus Volume in Normocephalic Nonsyndromic Sagittal Craniosynostosis: A Comparative Study.

Purpose: This study aimed to investigate frontal sinus volume as a potential indicator of cranial compensatory growth in unoperated normocephalic nonsyndromic sagittal craniosynostosis (NNSC) patients compared with age-matched and sex-matched controls. Previous studies have suggested that frontal sinus volume is suppressed in unoperated craniosynostosis and may be an intracranial space conservation phenomenon.

Methods: Head computed tomographies (CTs) from 22 unoperated NNSC patients at our institution were utilized in this study and matched with age-matched and sex-matched control subjects.

Impact of Social Vulnerability, Race, and Urbanicity on Surgical Timing for Patients With Craniosynostosis.

Prior studies have linked the timing of craniosynostosis surgeries to several postoperative outcomes. However, less is known regarding the influence of sociodemographic factors on surgical timing for this population. This study investigates the influence of social vulnerability index (SVI), race, and urbanicity on the timing of craniosynostosis surgery.

Recognizing Variations in Primary Palatoplasty Billing: A Review of 9827 Cases.

Objective: Identify unbundling trends in primary palatoplasty.

Design: Retrospective study utilizing the American College of Surgeon Pediatric National Surgical Quality Improvement Program (PNSQIP).

Setting: Records available from 2016 to 2021.

The Utility of Prophylactic Muscle Flaps in Complex Pediatric Spine Surgery.

Purpose: Complex spinal surgery in the pediatric population can lead to devastating complications and morbidity. Paraspinal muscle flaps are commonly performed after complications to optimize wound closure. However, some advocate for their prophylactic use at the index surgery.

Impact of Social Vulnerability, Race, and Urbanicity on Early Nutritional Outcomes in Patients With Cleft Palate.

Patients with cleft palate experience early feeding difficulties, resulting in increased hospital utilization due to poor nutritional status. Sociodemographic factors may impact access and outcomes for cleft patients. This study investigates the association of social vulnerability, race, and urbanicity on birth encounter metrics and failure to thrive (FTT) rates for patients with cleft palate.

"Craniometric and Volumetric Analyses of Normocephalic and Scaphocephalic Patients with Nonsyndromic Single-Suture Sagittal Craniosynostosis".

Purpose: Non-syndromic single-suture sagittal craniosynostosis presentation spans scaphocephalic and normocephalic head shapes. Herein, we studied craniometric differences between scaphocephalic and normocephalic patients with sagittal synostosis.

Methods: Head CT scans of 20 scaphocephalic and 20 normocephalic sagittal synostosis patients and their age- and sex-matched controls were analyzed, including cranial base angles, distances-from-midline, and intracranial volumes.

Cleft Lip Repair Comparison Between Inpatient and Outpatient Surgeries: A Multi-Surgeon Experience.

Objective: Great variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. This study's aim is to investigate the authors' institutional experience to see if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performed as outpatient.

Design: This study reviewed patients who underwent CL repair between 2012 and 2023 at the authors' institution.

Epidemiologic Assessment of Craniosynostosis in Mississippi's Pediatric Population from 2015 to 2020.

Objectives: This study aimed to report geographic and demographic patterns of patients with craniosynostosis (CS) treated at Children's of Mississippi, the state's only American Cleft Palate-Craniofacial Association-approved craniofacial team.

Methods: Patients with CS were treated at a tertiary pediatric hospital cared for by craniofacial surgeons and neurosurgeons from 2015 to 2020. Demographic, geographic, and CS diagnosis details, including sex, gestational age, race, ethnicity, insurance status, and affected cranial suture type(s), number, and associated syndromic diagnosis were collected, including birth county and total live births from state data.

Longitudinal Speech and Fistula Outcomes Following Primary Cleft Palate Repair at a Single Institution.

Introduction: Fistula formation and velopharyngeal insufficiency (VPI) are complications of cleft palate repair that often require surgical correction. The goal of the present study was to examine a single institution's experience with cleft palate repair with respect to fistula formation and need for surgery to correct velopharyngeal dysfunction.

Methods: Institutional review board approval was obtained.

Implementation of an Enhanced Recovery After Surgery Protocol for Cleft Palate Repair.

Objective: This study examines an Enhanced Recovery After Surgery (ERAS) protocol for patients with cleft palate and hypothesizes that patients who followed the protocol would have decreased hospital length of stay and decreased narcotic usage than those who did not.

Design: Retrospective cohort study.

Setting: The study takes place at a single tertiary children's hospital.

Plastic Surgery Outreach Clinics Expand Access to Cleft and Craniofacial Care in Mississippi.

Accessing treatment at ACPA (American Cleft Palate-Craniofacial Association)-approved centers is challenging for individuals in rural communities. This study aims to assess how pediatric plastic surgery outreach clinics impact access for patients with orofacial cleft and craniosynostosis in Mississippi. An isochrone map was used to determine mean travel times from Mississippi counties to the sole pediatric hospital and the only ACPA-approved team in the state.

The Fisher Subunit Anatomical Approach for Cleft Lip Revisions: An Evolution and Case Series.

Many techniques exist to reapproximate a cleft lip but can leave unsatisfactory results with nonanatomic scars and a short upper lip, creating a need for revision. Many revisions focus on adjacent tissue transfers and realignment of landmarks, but in the senior authors' experience, recreating the defect and utilizing the Fisher repair for revision have led to aesthetically pleasing results and less noticeable scars. A database was collected that included all cleft lip revisions performed at a large, comprehensive children's hospital from October 2018 to July 2021.

Epidemiologic Trends of Cleft Lip and Palate in a Southern State: A 30-Year Follow-Up.

Objectives: Children's of Mississippi at the University of Mississippi Medical Center serves as the state's only American Cleft Palate-Craniofacial Association-approved cleft team at the only pediatric hospital in the state. The goal of this study is to report geographic and demographic patterns of patients with orofacial cleft (OFC) treated at Children's of Mississippi, which are lacking.

Methods: Patients with OFC treated at Children's of Mississippi from 2015 to 2020 were included.

Patients Requiring Multiple Surgeries for Velopharyngeal Insufficiency: Findings From a 10-Year Retrospective Review.

This study analyzed patients undergoing multiple surgeries for velopharyngeal insufficiency (VPI) and reviewed their preoperative evaluations and techniques selected for subsequent surgeries. A retrospective chart review was performed including patients having undergone multiple surgeries for VPI at the authors' institution between 2012 and 2022. All patients were evaluated and managed at the author's institution under the direction of 4 senior surgeons.

Posterior Vault Distraction in the Acute Setting.

Posterior vault distraction osteogenesis (PVDO) has been shown to resolve acute intracranial hypertension (AIH) while carrying an acceptable perioperative morbidity profile. PVDO has been associated with symptomatic improvement and fewer surgeries in those requiring ventriculoperitoneal shunts. The authors' experience using PVDO as an acute intervention is presented, demonstrating its safety and efficacy for management of AIH.

Mandibular Distraction in Patients With Pierre Robin Sequence: A Multisurgeon Experience.

Objective: Mandibular distraction osteogenesis (MDO) is rapidly becoming a standard of care for management of patients with severe Pierre Robin sequence. The tongue is brought forward to alleviate airway obstruction. This study will look at an institutional, multisurgeon experience with MDO over 10 years.

Travel Burden to American Cleft Palate and Craniofacial Association-Approved Cleft and Craniofacial Teams: A Geospatial Analysis.

Background: Despite the existence of cleft and craniofacial teams approved by the American Cleft Palate and Craniofacial Association (ACPA), access to multidisciplinary team-based care remains challenging for patients from rural areas, leading to disparities in care. The authors investigated the geospatial relationship between US counties and ACPA-approved centers.

Methods: The geographic location of all ACPA-approved cleft and craniofacial centers in the United States was identified.

Perioperative Management of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis Undergoing LeFort III Osteotomy With Distraction: A Case Series.

Study Design: Retrospective observational study.

Objective: The purpose of this publication is to address the absence of literature detailing respiratory management in patients with syndromic craniosynostosis and obstructive sleep apnea during the immediate postoperative interval following LeFort III advancement with placement of distraction hardware but prior to sufficient midface advancement.

Methods: After IRB approval, the investigators retrospectively selected candidates for inclusion in this case series.

Access to Certified Burn Centers in the United States: The Geospatial and Transport Cost of Transfer.

Specialized burn centers are critical to minimizing burn-associated morbidity and mortality. However, American Burn Association-verified burn centers are unequally distributed across the United States, and fewer centers are available for pediatric patients relative to adults. The economic burden of transporting patients to these centers contributes significantly to the high cost of burn care.

Dr. ChatGPT: Utilizing Artificial Intelligence in Surgical Education.

Objective: This study sought to explore the unexamined capabilities of ChatGPT in describing the surgical steps of a specialized operation, the Fisher cleft lip repair.

Design: A chat log within ChatGPT was created to generate the procedural steps of a cleft lip repair utilizing the Fisher technique. A board certified craniomaxillofacial (CMF) surgeon then wrote the Fisher repair in his own words blinded to the ChatGPT response.