Systematic Review and Critical Appraisal of the Evidence Base for Nasoalveolar Molding (NAM).

Objective: To critically appraise the body of scientific literature supporting the risks and efficacy of nasoalveolar molding (NAM), specifically in contrast to alternative methods of presurgical infant orthopedics (PSIO) or to treatment without PSIO.

Main Outcome Measures: Five outcome domains were considered: nasolabial aesthetics; dentoalveolar relationship; midfacial growth; cost and burden of care; and number of anesthetic events.

Design: MEDLINE, Embase, and Scopus were queried for articles from the first description of the Grayson-Santiago NAM technique (1993) through December 13, 2021.

Left Ophthalmic Segment Internal Carotid Artery Aneurysm Treated with Flow Diversion in a Child with Apert Syndrome: Technical Note.

Introduction: Prevalence of intracranial aneurysms in children with Apert syndrome has not been described, and development of an aneurysm as a complication secondary to craniofacial surgery has never been reported.

Case Presentation: We report the rare case of a 10-year-old boy with Apert syndrome who underwent craniofacial reconstruction surgery consisting of subcranial Le Fort III osteotomies, bilateral lateral canthopexies, and nasal nares dilations for midfacial hypoplasia and resultant obstructive sleep apnea, and on routine follow-up magnetic resonance imaging (MRI) 1 year later, he was found to have a large left ophthalmic internal carotid artery (ICA) aneurysm that was not seen on MRI obtained 2 years prior. Immediately after the craniofacial surgery, the patient experienced a severe headache behind his left eye and extraocular movement abnormalities that subsided over the next days to months.

Associations between temperament dimensions and dental anxiety in parents of the FinnBrain Birth Cohort Study.

We evaluated associations between dental anxiety and four temperament dimensions: effortful control, extraversion/surgency, negative affect and orienting sensitivity among 2558 parents in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale, and temperament with the Adult Temperament Questionnaire. Associations between dental anxiety and temperament dimensions were modelled using linear and logistic (cut-off ≥ 19 for high dental anxiety) regression analyses adjusting for general anxiety and depressive symptoms, age and education.

Triple Assessment of a Palpable Parotid Lump in "One-Stop" Clinics.

Introduction: The National Institute of Clinical Excellence in the UK (NICE) recommended the use of "one-stop" clinics for the assessment and management of head and neck lumps like those established for breast lumps. "One-stop" clinics should follow a triple assessment protocol involving physical examination, radiological imaging and fine-needle aspiration cytology (FNAC).

Methods: A retrospective analysis of 144 patients with suspected parotid tumours from 2005 to 2011 was done.

25-year Follow-up of Primary Tibial Periosteal Graft for Hard Palate Repair in Cleft Lip and Palate: Outcomes, Concerns and Controversies.

Objective: This study evaluates long-term outcomes in adults with Unilateral and Bilateral Cleft Lip and Palate (UCLP/BCLP) treated during the period 1992 to 1995 with tibial periosteal graft in primary repair.

Design: Retrospective study.

Setting: Department of Plastic and Maxillofacial Surgery, Children's Hospital Bambino Gesù (Italy).

Endoscopic Strip Craniectomy and Helmet Therapy for Sagittal Craniosynostosis: An Analysis of Cranial Growth Changes in the Early Postoperative Period.

Objective: The purpose of this study is to analyze cranial width and length growth curves in the early postoperative period of patients by undergoing endoscopic sagittal strip craniectomy (ESC) to determine the timing of the maximal growth curve change. By analyzing the complex interplay of cephalic length and width measurements, we hope to better understand the cephalic index (CI) growth curve during this early period. This is the first of a multistep process to elucidate the ideal cranial remolding orthosis (CRO) treatment duration.

Limited Access to Alveolar Bone Graft Surgery Following Primary Cleft Lip and Palate Repair in Indonesia: A Questionnaire-Based Qualitative Study.

Introduction: Cleft Lip and Palate is the most common craniofacial anomaly, and cleft lip and palate repair is widely performed. Alveolar cleft accompanies 75% of cleft lip cases and requires alveolar bone graft (ABG) surgery at mixed dentition age. However, studies on rates of ABG surgery are scarce.

Comparison of regional soft tissue changes after bimaxillary rotational surgery between class III deformity with overbite and open bite: A 3D imaging analysis.

Background: This prospective study aimed to compare regional soft tissue changes between patients with class III overbite and open bite deformities treated with bimaxillary surgery involving clockwise and counter-clockwise mandibular setback, respectively.

Material And Methods: Class III deformity adults receiving Le Fort I and bilateral sagittal split osteotomies were grouped according to the incisal occlusion: overbite (n = 30) and open bite (n = 30). Combined cone-beam CT scans and 3D facial photographs preoperative and at least 1-year postoperative were taken to assess the soft tissue changes.

Caregiver Observations of Infant Well-Being Before and After Cleft Lip Surgery.

Objective: To evaluate the sensitivity to change of daily ratings of the comfort (COMF) and behavioral/emotional health (BEH) domains of the Infants with Clefts Observation Outcomes Instrument (iCOO) at 3 time points, and to assess the association of post-surgical interventions on iCOO ratings.

Design: The COMF and BEH domains were completed by caregivers before (T0), immediately after (T1), and 2-months after (T2) cleft lip (CL) surgery. Analyses included descriptive statistics, correlations, -tests, and generalized estimating equations.

Facial asymmetry in children with either unilateral lambdoid craniosynostosis or positional posterior plagiocephaly.

Background: In unilateral lambdoid craniosynostosis (ULC), the posteriorly situated lambdoid suture of the cranial vault fuses prematurely. Positional posterior plagiocephaly (PPP) causes flattening of the posterior side of the head, either through external forces or through underlying differences in brain development. Both conditions cause occipital flattening of the head, but the aetiology is different.

Perioperative Morbidity of Secondary Frontal Orbital Advancement After Initial Frontal Orbital Advancement.

Frontal orbital advancement (FOA) is frequently performed for patients with syndromic and/or multisuture craniosynostosis. A small proportion of patients who undergo FOA have unfavorable growth and subsequently require a second FOA later in life; however, the perioperative risks associated with this second procedure are not well studied. We report results from a retrospective review of FOAs conducted from 2007 to 2022 at a single site with the same craniofacial surgeon.

Alpelisib for the treatment of PIK3CA-related head and neck lymphatic malformations and overgrowth.

Purpose: PIK3CA-related overgrowth spectrum (PROS) conditions of the head and neck are treatment challenges. Traditionally, these conditions require multiple invasive interventions, with incomplete malformation removal, disfigurement, and possible dysfunction. Use of the PI3K inhibitor alpelisib, previously shown to be effective in PROS, has not been reported in PIK3CA-associated head and neck lymphatic malformations (HNLMs) or facial infiltrating lipomatosis (FIL).

Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden.

Objectives: Facial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and/or palate (CL/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL/P and characterizes the degree of FDD symptoms in an adult craniofacial population.

Speech Symptoms of Velopharyngeal Insufficiency and the Incidence of Secondary Speech Surgery in 10-Year-Old Children With Unilateral Cleft Lip and Palate: Comparison of 2 Randomized Surgical Methods for Primary Palatal Surgery.

Objective: To compare speech symptoms of velopharyngeal insufficiency (VPI) and incidence of secondary speech surgery in 10-year-old Finnish children with unilateral cleft lip and palate (UCLP) following primary palatal surgery using 2 surgical methods.

Design: Single center analysis within the Scandcleft multicenter randomized controlled trial of primary surgery for UCLP.

Materials And Methods: Patients comprised 79 nonsyndromic 10-year-old children with UCLP.

The use of OCT to detect signs of intracranial hypertension in patients with sagittal suture synostosis: Reference values and correlations.

Purpose: To obtain pediatric normative reference values and determine whether optical coherence tomography (OCT) corresponds better with clinical signs of intracranial hypertension (ICH) compared to the traditional screening method fundoscopy in a large cohort of one type of single suture craniosynostosis.

Methods: Control subjects without optic nerve diseases and isolated sagittal synostosis patients aged 3-10 years who underwent fundoscopy and OCT were included in this prospective cohort study. Normative reference values were obtained through bootstrap analysis.

Enhanced recovery after cleft palate repair: A quality improvement project.

Background: Children undergoing cleft palate repair present challenges to postoperative management due to several factors that can complicate recovery. Utilization of multimodal analgesic protocols can improve outcomes in this population. We report experience designing and implementing an enhanced recovery after surgery (ERAS) pathway for cleft palate repair to optimize postoperative recovery.

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multidisciplinary Expert Consensus.

Background: The objective of this study was to develop guidelines for the transfer of patients with isolated craniomaxillofacial trauma.

Methods: A national, multidisciplinary expert panel was assembled from leadership in national organizations and contributors to published literature on facial reconstruction. The final panel consisted of five plastic surgeons, four otolaryngologist-head and neck surgeons, and four oral and maxillofacial surgeons.

Screening for Academic Risk Among Students With Cleft Lip and/or Palate: Patterns of Risk and Qualities of Effective Tools.

This study evaluated the effectiveness of academic screening measures in relation to parent-reported diagnoses. Multicenter, retrospective cohort study including structured interviews, questionnaires, and chart reviews. Six North American cleft centers.

Craniofacial Morphologic Predictors for Passive Myofunctional Therapy of Pediatric Obstructive Sleep Apnea Using an Oral Appliance with a Tongue Bead.

We conducted this retrospective study to identify potential clinical, polysomnographic, and cephalometric predictors for the treatment outcomes of a tongue-beaded oral appliance (OA) in children with obstructive sleep apnea syndrome (OSAS). In total, 63 patients—50 boys and 13 girls ranging in age from 4 to 16 years—underwent OA treatment nightly for at least 6 months. A baseline digital lateral cephalometric radiograph was obtained for each patient.

Validating Spectral Moment Analysis as a Quantitative Measure of Speech Distortions in Speakers With Class III Malocclusions.

Purpose: This study examined the relationship between judged speech sound distortions and spectral moment metrics in speakers with Class III malocclusion.

Methods: A quantitative online survey was distributed to 30 speech specialists (clinicians and/or students) and 100 lay listeners to judge the clarity of the sounds /s/, /ʃ/, /t/ and /k/ using a visual analog scale (VAS) from recordings of 11 Class III (underbite) Dentofacial Disharmony (DFD) patients and eight Class I controls. Patients and controls were grouped according to high, moderate, and low /s/-/ʃ/ first spectral moment differences.

The effect of natural growth on chin point deviation in patients with unilateral craniofacial microsomia: A retrospective study.

This study aimed to investigate the potential progressiveness of mandibular asymmetry and to study factors that influence chin point deviation in patients with unilateral craniofacial microsomia (CFM). Paediatric patients with unilateral CFM with available radiologic imaging and medical photographs were included. Chin point deviation was measured on clinical photographs.

Craniofacial structures, occlusal features, and TMD symptoms in juvenile idiopathic arthritis patients: a retrospective study.

Background: Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease in which temporomandibular joint (TMJ) arthritis commonly occurs. It may be asymptomatic and could cause problems in the growing joints. Our aim was to evaluate the craniofacial structures, occlusal features and temporomandibular dysfunction (TMD) symptoms of patients with JIA.

Missense variants in ANKRD11 cause KBG syndrome by impairment of stability or transcriptional activity of the encoded protein.

Purpose: Although haploinsufficiency of ANKRD11 is among the most common genetic causes of neurodevelopmental disorders, the role of rare ANKRD11 missense variation remains unclear. We characterized clinical, molecular, and functional spectra of ANKRD11 missense variants.

Methods: We collected clinical information of individuals with ANKRD11 missense variants and evaluated phenotypic fit to KBG syndrome.