Evidence map›Paper›PMID 37441787›Full record

ArticleThe Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association2024

Surgery for Velopharyngeal Insufficiency Following Cleft Palate Repair: An Audit of Contemporary Practice and Proposed Schema of Techniques and Variations.

Raymond W Tse, Kathleen C Sie, Travis T Tollefson, Oksana A Jackson, Richard Kirshner, David M Fisher, Randall Bly, Jugpal S Arneja, John P Dahl, Magdalena Soldanska and 1 more

Open access · greenAbstract read
In one paragraph

Article in The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. An Exploratory Investigation into the Influence of Nasopharyngoscopy Findings on VPI Surgery Selection.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026
    Article
  3. Do Palatoplasty Procedures Resolve Hypernasality as Effectively as Pharyngoplasty Procedures in Patients with 22q11.2 Deletion Syndrome?The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Raymond W TseCraniofacial and Pediatric Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA.ORCID 0000-0002-0179-9809
Kathleen C SieOtolaryngology, Seattle Children's Hospital, Seattle, WA, USA.
Travis T TollefsonOtolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA.
Oksana A JacksonPlastic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-8119-9442
Richard KirshnerPlastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
David M FisherPlastic Surgery, The Hospital for Sick Children, Toronto, ON, USA.
Randall BlyOtolaryngology, Seattle Children's Hospital, Seattle, WA, USA.
Jugpal S ArnejaPlastic Surgery, BC Children's Hospital, Vancouver, BC, USA.
John P DahlOtolaryngology, Seattle Children's Hospital, Seattle, WA, USA.
Magdalena SoldanskaPlastic Surgery, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Thomas J SitzmanPlastic Surgery, Phoenix Children's Hospital, Phoenix, Arizona, USA.ORCID 0000-0002-2173-923X
Seattle Children's Hospital · USChildren's Healthcare of Atlanta · USChildren's Hospital of Philadelphia · USNationwide Children's Hospital · USPhoenix Children's Hospital · USUniversity of California, Davis · US

Funding

Velopharyngeal insufficiency following cleft palate repair: a comparative effectiveness study of existing surgical procedures and identification of criteria to guide a personalized treatment approachU01DE029750 · NIDCR · PHOENIX CHILDREN'S HOSPITAL · PI SITZMAN, THOMAS JAMES · 2020 to 2024
$4.2M
NIDCR NIH HHS U01 DE029750
6 · The paper itself

Abstract

objectiveSurgical treatment of velopharyngeal insufficiency (VPI) includes a wide array of procedures. The purpose of this study was to develop a classification for VPI procedures and to describe variations in how they are performed.

resultsProcedures were divided into three groups: palate-based surgery; pharynx-based surgery; and augmentation. Palate-based operations included straight line mucosal incision with intravelar veloplasty, double-opposing Z-plasty, and palate lengthening with buccal myomucosal flaps. Many surgeons blended maneuvers from these three techniques, so a more descriptive schema was developed classifying the maneuvers employed on the oral mucosa, nasal mucosa, and muscle. Pharynx-based surgery included pharyngeal flap and sphincter pharyngoplasty, with variations in design for each. Augmentation procedures included palate and posterior wall augmentation.

conclusionsA comprehensive schema for VPI procedures was developed incorporating intentional adaptations in technique. There was substantial variation amongst surgeons in how each procedure was performed. The schema may enable more specific evaluations of surgical outcomes and exploration of the mechanisms through which these procedures improve speech.

Indexed as

Cleft PalateVelopharyngeal InsufficiencyCanadaHumansPlastic Surgery ProceduresPractice Patterns, Physicians'Surgical FlapsUnited Statescleft palatepalatoplastypharyngoplastysurgeryvelopharyngeal insufficiency

Identifiers

PMID37441787
PMCPMC10787042
OpenAlexW4384155719

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.