Evidence map›Paper›PMID 40665693›Full record

ArticleThe Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association2026

An Exploratory Investigation into the Influence of Nasopharyngoscopy Findings on VPI Surgery Selection.

Jessica L Chee-Williams, Jamie L Perry, Kate Bunton, Thomas J Sitzman

Abstract read
In one paragraph

Article in The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

4 authors.

Jessica L Chee-WilliamsPhoenix Children's Center for Cleft and Craniofacial, Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.ORCID 0000-0002-2882-7275
Jamie L PerryDepartment of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA.ORCID 0000-0001-7866-9159
Kate BuntonDepartment of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ, USA.
Thomas J SitzmanPhoenix Children's Center for Cleft and Craniofacial, Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.ORCID 0000-0002-2173-923X

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

ObjectiveTo explore if observations on nasopharyngoscopy influence the surgical procedure selected for the management of velopharyngeal insufficiency (VPI).DesignCross-sectional survey.ParticipantsSeventeen surgeons with experience treating VPI.InterventionsReview of twenty-four nasopharyngoscopy videos with a combination of velopharyngeal closure patterns and gap sizes.Main Outcome MeasuresSurgical procedure was selected after watching a nasopharyngoscopy video. Chi-square tests were used to evaluate if, for each surgeon, procedure selection varied based on closure pattern and gap size combination. Variable importance scores were obtained from a random forest analysis to quantify contribution of nasopharyngoscopy observations on procedure selection.ResultsFour procedures accounted for 86% of all surgeries selected: Furlow double-opposing Z-Plasty (33%), palatal lengthening using buccal myomucosal flaps (20%), pharyngeal flap (19%), and sphincter pharyngoplasty (14%). Four surgeons (23.5%) significantly varied their surgical selection when different closure pattern and gap size combinations were shown on nasopharyngoscopy. Ten surgeons (58%) selected the same procedure in ≥ 50% of the 24 nasopharyngoscopy videos. Individual surgeon preference was the strongest predictor of surgical selection, accounting for 57.9% of surgical selection variance. Velopharyngeal gap size accounted for 36.5% of the variance in surgical selection, yet the specific surgeries selected based on gap size varied widely across surgeons. Closure pattern was a weak predictor, contributing 5.6% to surgical selection variance.ConclusionsNasopharyngoscopy findings influence VPI surgical procedure selection in a highly individualized, surgeon-specific manner. Among factors observed on nasopharyngoscopy, velopharyngeal gap size has a much larger influence on procedure selection than closure pattern.

Indexed as

EndoscopyVelopharyngeal InsufficiencyCross-Sectional StudiesHumansSurgical FlapsVideo RecordingimagingnasopharyngoscopyVPI

Identifiers

PMID40665693
PMCPMC12415720

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.