Skip to main content

Alexander C Allori

Associate Professor of Surgery
Surgery, Plastic, Maxillofacial, and Oral Surgery

Selected Publications


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

Journal Article Cleft Palate Craniofac J · April 2024 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 ... Full text Link to item Cite

Improving Health Literacy of Elective Procedures in Pediatric Otolaryngology.

Journal Article Otolaryngol Head Neck Surg · March 23, 2024 OBJECTIVE: To identify if the addition of supplementary material, such as video or written resources, to the consent process, can improve a patient's or guardian's health literacy in pediatric otolaryngology. STUDY DESIGN: Prospective randomized crossover ... Full text Link to item Cite

Most Efficient and Meaningful Patient-Reported Appearance Assessment in Different Cleft Types and Age Groups with CLEFT-Q.

Journal Article Plast Reconstr Surg · January 1, 2024 BACKGROUND: The CLEFT-Q, a questionnaire developed and validated specifically for cleft patients, contains seven appearance scales. The International Consortium of Health Outcomes Measurement (ICHOM) has incorporated only some CLEFT-Q appearance scales in ... Full text Link to item Cite

Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate.

Journal Article Plast Reconstr Surg Glob Open · January 2024 BACKGROUND: The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal compete ... Full text Link to item Cite

What is the optimal assessment of speech? A multicentre, international evaluation of speech assessment in 2500 patients with a cleft.

Journal Article BMJ Open · December 28, 2023 OBJECTIVES: Speech problems in patients with a cleft palate are often complex and multifactorial. Finding the optimal way of monitoring these problems is challenging. The International Consortium of Health Outcomes Measurement (ICHOM) has developed a set o ... Full text Link to item Cite

Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network.

Journal Article Cleft Palate Craniofac J · October 16, 2023 OBJECTIVE: To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study fin ... Full text Link to item Cite

Measuring the Unilateral Cleft Lip Nasal Deformity: Lateral Deviation of Subnasale Is a Clinical and Morphologic Index of Unrepaired Severity.

Journal Article Cleft Palate Craniofac J · October 3, 2023 OBJECTIVE: Objective measurement of pre-operative severity is important to optimize evidence-based practices given that the wide spectrum of presentation likely influences outcomes. The purpose of this study was to determine the correlation of objective me ... Full text Link to item Cite

Aesthetic Outcomes in Cleft Care: Exploring Patterns in Patient-Reported Outcomes Across Adolescence.

Journal Article Plast Reconstr Surg · September 29, 2023 BACKGROUND: For patients with cleft lip/palate, adolescence is a time of maxillofacial growth and complex psychosocial stressors. The personal significance of facial differences may change, making patient-reported outcomes measures (PROMs) invaluable. In t ... Full text Link to item Cite

Relevance of cleft palatal width in short-term otologic outcomes.

Journal Article Int J Pediatr Otorhinolaryngol · August 2023 OBJECTIVE: Children with cleft palate are at increased risk for Eustachian tube dysfunction (ETD) and conductive hearing loss from chronic otitis media. While it has been proposed that the severity of ETD is related to the severity of cleft palate, data ar ... Full text Link to item Cite

The Development, Deployment, and Evaluation of the CLEFT-Q Computerized Adaptive Test: A Multimethods Approach Contributing to Personalized, Person-Centered Health Assessments in Plastic Surgery.

Journal Article Journal of medical Internet research · April 2023 BackgroundRoutine use of patient-reported outcome measures (PROMs) and computerized adaptive tests (CATs) may improve care in a range of surgical conditions. However, most available CATs are neither condition-specific nor coproduced with patients ... Full text Cite

The past, present and future of ACS NSQIP-Pediatric: Evolution from a quality registry to a comparative quality performance platform.

Journal Article Semin Pediatr Surg · April 2023 Quality and process improvement (QI/PI) in children's surgical care require reliable data across the care continuum. Since 2012, the American College of Surgeons' (ACS) National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) has supported ... Full text Link to item Cite

Computational Analyses of Physiologic Effects After Midvault Repair Techniques in Rhinoplasty

Journal Article Face · March 1, 2023 Background: Midvault reconstruction is an essential element of functional rhinoplasty. An improved understanding of airflow patterns after spreader graft (SG) or spreader flap (SF) techniques can inform surgical techniques based on individual anatomy. Obje ... Full text Open Access Cite

Optimizing the Psychosocial Function Measures in the International Consortium for Health Outcomes Measurement Standard Set for Cleft.

Journal Article Plast Reconstr Surg · February 1, 2023 BACKGROUND: To ensure the feasibility of implementing PROMs in clinical practice, they must be continually appraised for undue burden placed on patients and clinicians and their usefulness for decision-making. This study assesses correlations between the C ... Full text Link to item Cite

Correlation Between Postoperative Antimicrobial Prophylaxis Use and Surgical Site Infection in Children Undergoing Nonemergent Surgery.

Journal Article JAMA Surg · December 1, 2022 IMPORTANCE: Use of postoperative antimicrobial prophylaxis is common in pediatric surgery despite consensus guidelines recommending discontinuation following incision closure. The association between postoperative prophylaxis use and surgical site infectio ... Full text Link to item Cite

Predictors of Blood Transfusion for Endoscopic Assisted Craniosynostosis Surgery.

Journal Article J Craniofac Surg · July 2022 Blood loss is a main cause of morbidity after craniofacial procedures. The purpose of this study is to identify the incidence and predictors for transfusion of blood products in the endoscopic assisted strip craniectomy population. Data was prospectively c ... Full text Link to item Cite

Barriers and Facilitators to the International Implementation of Standardized Outcome Measures in Clinical Cleft Practice.

Journal Article Cleft Palate Craniofac J · January 2022 OBJECTIVE: To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care. DESIGN: Cleft teams that have implemented the International Consortium for Health Outcomes Measure ... Full text Link to item Cite

A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.

Journal Article Int J Comput Assist Radiol Surg · January 2022 PURPOSE: Individuals with unilateral cleft lip nasal deformity (uCLND) often require rhinoplasty in adolescence to correct nasal obstruction. The intent of this study is to identify sites of greatest nasal obstruction and evaluate the effects of isolated a ... Full text Link to item Cite

Rasch Analysis of Patient- and Parent-Reported Outcome Measures in the International Consortium for Health Outcomes Measurement Standard Set for Cleft Lip and Palate.

Journal Article Value Health · March 2021 OBJECTIVES: The aim of this study was to evaluate the psychometric performance of the patient- and parent-reported measures in the International Consortium for Health Outcomes Measurement (ICHOM) Standard Set for Cleft Care, and to identify ways of improvi ... Full text Link to item Cite

Time-Driven, Activity-Based Costing of Presurgical Infant Orthopedics: A Critical Component of Establishing Value of Latham Appliance and Nasoalveolar Molding.

Journal Article Plast Reconstr Surg · March 1, 2021 BACKGROUND: Value-based health-care reform requires assessment of outcomes and costs of medical interventions. In cleft care, presurgical infant orthopedics is still being evaluated for clinical benefits and risks; however, the cost of these procedures has ... Full text Link to item Cite

A Toolbox of Surgical Techniques for Palatal Fistula Repair.

Journal Article Cleft Palate Craniofac J · February 2021 OBJECTIVE: To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. DESIGN: A 4-stage approach was used to develop a consensus on surgical techniques available for ... Full text Link to item Cite

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

Journal Article Cleft Palate Craniofac J · April 2024 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 ... Full text Link to item Cite

Improving Health Literacy of Elective Procedures in Pediatric Otolaryngology.

Journal Article Otolaryngol Head Neck Surg · March 23, 2024 OBJECTIVE: To identify if the addition of supplementary material, such as video or written resources, to the consent process, can improve a patient's or guardian's health literacy in pediatric otolaryngology. STUDY DESIGN: Prospective randomized crossover ... Full text Link to item Cite

Most Efficient and Meaningful Patient-Reported Appearance Assessment in Different Cleft Types and Age Groups with CLEFT-Q.

Journal Article Plast Reconstr Surg · January 1, 2024 BACKGROUND: The CLEFT-Q, a questionnaire developed and validated specifically for cleft patients, contains seven appearance scales. The International Consortium of Health Outcomes Measurement (ICHOM) has incorporated only some CLEFT-Q appearance scales in ... Full text Link to item Cite

Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate.

Journal Article Plast Reconstr Surg Glob Open · January 2024 BACKGROUND: The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal compete ... Full text Link to item Cite

What is the optimal assessment of speech? A multicentre, international evaluation of speech assessment in 2500 patients with a cleft.

Journal Article BMJ Open · December 28, 2023 OBJECTIVES: Speech problems in patients with a cleft palate are often complex and multifactorial. Finding the optimal way of monitoring these problems is challenging. The International Consortium of Health Outcomes Measurement (ICHOM) has developed a set o ... Full text Link to item Cite

Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network.

Journal Article Cleft Palate Craniofac J · October 16, 2023 OBJECTIVE: To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study fin ... Full text Link to item Cite

Measuring the Unilateral Cleft Lip Nasal Deformity: Lateral Deviation of Subnasale Is a Clinical and Morphologic Index of Unrepaired Severity.

Journal Article Cleft Palate Craniofac J · October 3, 2023 OBJECTIVE: Objective measurement of pre-operative severity is important to optimize evidence-based practices given that the wide spectrum of presentation likely influences outcomes. The purpose of this study was to determine the correlation of objective me ... Full text Link to item Cite

Aesthetic Outcomes in Cleft Care: Exploring Patterns in Patient-Reported Outcomes Across Adolescence.

Journal Article Plast Reconstr Surg · September 29, 2023 BACKGROUND: For patients with cleft lip/palate, adolescence is a time of maxillofacial growth and complex psychosocial stressors. The personal significance of facial differences may change, making patient-reported outcomes measures (PROMs) invaluable. In t ... Full text Link to item Cite

Relevance of cleft palatal width in short-term otologic outcomes.

Journal Article Int J Pediatr Otorhinolaryngol · August 2023 OBJECTIVE: Children with cleft palate are at increased risk for Eustachian tube dysfunction (ETD) and conductive hearing loss from chronic otitis media. While it has been proposed that the severity of ETD is related to the severity of cleft palate, data ar ... Full text Link to item Cite

The Development, Deployment, and Evaluation of the CLEFT-Q Computerized Adaptive Test: A Multimethods Approach Contributing to Personalized, Person-Centered Health Assessments in Plastic Surgery.

Journal Article Journal of medical Internet research · April 2023 BackgroundRoutine use of patient-reported outcome measures (PROMs) and computerized adaptive tests (CATs) may improve care in a range of surgical conditions. However, most available CATs are neither condition-specific nor coproduced with patients ... Full text Cite

The past, present and future of ACS NSQIP-Pediatric: Evolution from a quality registry to a comparative quality performance platform.

Journal Article Semin Pediatr Surg · April 2023 Quality and process improvement (QI/PI) in children's surgical care require reliable data across the care continuum. Since 2012, the American College of Surgeons' (ACS) National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) has supported ... Full text Link to item Cite

Computational Analyses of Physiologic Effects After Midvault Repair Techniques in Rhinoplasty

Journal Article Face · March 1, 2023 Background: Midvault reconstruction is an essential element of functional rhinoplasty. An improved understanding of airflow patterns after spreader graft (SG) or spreader flap (SF) techniques can inform surgical techniques based on individual anatomy. Obje ... Full text Open Access Cite

Optimizing the Psychosocial Function Measures in the International Consortium for Health Outcomes Measurement Standard Set for Cleft.

Journal Article Plast Reconstr Surg · February 1, 2023 BACKGROUND: To ensure the feasibility of implementing PROMs in clinical practice, they must be continually appraised for undue burden placed on patients and clinicians and their usefulness for decision-making. This study assesses correlations between the C ... Full text Link to item Cite

Correlation Between Postoperative Antimicrobial Prophylaxis Use and Surgical Site Infection in Children Undergoing Nonemergent Surgery.

Journal Article JAMA Surg · December 1, 2022 IMPORTANCE: Use of postoperative antimicrobial prophylaxis is common in pediatric surgery despite consensus guidelines recommending discontinuation following incision closure. The association between postoperative prophylaxis use and surgical site infectio ... Full text Link to item Cite

Predictors of Blood Transfusion for Endoscopic Assisted Craniosynostosis Surgery.

Journal Article J Craniofac Surg · July 2022 Blood loss is a main cause of morbidity after craniofacial procedures. The purpose of this study is to identify the incidence and predictors for transfusion of blood products in the endoscopic assisted strip craniectomy population. Data was prospectively c ... Full text Link to item Cite

Barriers and Facilitators to the International Implementation of Standardized Outcome Measures in Clinical Cleft Practice.

Journal Article Cleft Palate Craniofac J · January 2022 OBJECTIVE: To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care. DESIGN: Cleft teams that have implemented the International Consortium for Health Outcomes Measure ... Full text Link to item Cite

A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.

Journal Article Int J Comput Assist Radiol Surg · January 2022 PURPOSE: Individuals with unilateral cleft lip nasal deformity (uCLND) often require rhinoplasty in adolescence to correct nasal obstruction. The intent of this study is to identify sites of greatest nasal obstruction and evaluate the effects of isolated a ... Full text Link to item Cite

Rasch Analysis of Patient- and Parent-Reported Outcome Measures in the International Consortium for Health Outcomes Measurement Standard Set for Cleft Lip and Palate.

Journal Article Value Health · March 2021 OBJECTIVES: The aim of this study was to evaluate the psychometric performance of the patient- and parent-reported measures in the International Consortium for Health Outcomes Measurement (ICHOM) Standard Set for Cleft Care, and to identify ways of improvi ... Full text Link to item Cite

Time-Driven, Activity-Based Costing of Presurgical Infant Orthopedics: A Critical Component of Establishing Value of Latham Appliance and Nasoalveolar Molding.

Journal Article Plast Reconstr Surg · March 1, 2021 BACKGROUND: Value-based health-care reform requires assessment of outcomes and costs of medical interventions. In cleft care, presurgical infant orthopedics is still being evaluated for clinical benefits and risks; however, the cost of these procedures has ... Full text Link to item Cite

A Toolbox of Surgical Techniques for Palatal Fistula Repair.

Journal Article Cleft Palate Craniofac J · February 2021 OBJECTIVE: To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. DESIGN: A 4-stage approach was used to develop a consensus on surgical techniques available for ... Full text Link to item Cite

Provision and Utilization of Team- and Community-Based Operative Care for Patients With Cleft Lip/Palate in North Carolina.

Journal Article Cleft Palate Craniofac J · November 2020 OBJECTIVE: To characterize operative care for cleft lip and/or palate (CL/P) based on location (ie, from American Cleft Palate Craniofacial Association [ACPA]-approved multidisciplinary teams or from community providers). DESIGN: Cross-sectional analysis o ... Full text Open Access Link to item Cite

Videoscope-Assisted Cleft Palate Surgery: Rationale, Experience, and Technical Implementation.

Journal Article Plast Reconstr Surg · November 2020 Limited visibility characteristic of cleft palate repair presents both ergonomic and educational challenges to cleft surgeons. Despite widespread recognition and reporting, posture-related spine disorders continue to represent a significant and potentially ... Full text Link to item Cite

Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial.

Journal Article Plast Reconstr Surg · July 2020 BACKGROUND: Improving surgeons' technical performance may reduce their frequency of postoperative complications. The authors conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgi ... Full text Link to item Cite

Decision-Making in Middle Vault Reconstruction following Dorsal Hump Reduction in Primary Rhinoplasty.

Journal Article Plast Reconstr Surg · June 2020 BACKGROUND: Dorsal hump reduction during open rhinoplasty disrupts the continuity between the upper lateral cartilages and the dorsal septum. Options to reconstitute the midvault include primary closure of the upper lateral cartilages to the dorsal aspect ... Full text Link to item Cite

Maximizing Plastic Surgery Education Impact: Lessons from Resident Learning Styles and Experiential Learning Theory.

Conference Plast Reconstr Surg Glob Open · July 2019 UNLABELLED: Residents in many surgical disciplines express a strong preference for hands-on learning, but no studies have focused on plastic surgery. This initial study aims to ascertain the learning styles of plastic surgery residents, and identify potent ... Full text Link to item Cite

Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency.

Journal Article Plast Reconstr Surg Glob Open · May 2019 BACKGROUND: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction re ... Full text Open Access Link to item Cite

Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care.

Journal Article Clin Pediatr (Phila) · April 2019 The impact of the Patient Protection and Affordable Care Act (PPACA) on children's access to surgical care is not well-defined. Our objective was to describe the early impact of PPACA on children's surgical care before and after Medicaid expansion in 2014. ... Full text Link to item Cite

The Utilization of Video Technology in Surgical Education: A Systematic Review.

Journal Article J Surg Res · March 2019 BACKGROUND: The use of surgical video has great potential to enhance surgical education, but there exists limited information about how to effectively use surgical videos. We performed a systematic review of video technology in surgical training and provid ... Full text Link to item Cite

Multimodal Characterization of the Mature Septal Deformity and Airspace Associated with Unilateral Cleft Lip and Palate.

Journal Article Plast Reconstr Surg · March 2019 BACKGROUND: The nasal deformity that accompanies cleft conditions is often acknowledged as the most difficult obstacle to restoring facial balance in affected children. Despite considerable progress in the treatment of cleft lip and palate, the outcomes of ... Full text Link to item Cite

Special education use in elementary school by children with nonsyndromic orofacial clefts.

Journal Article Birth Defects Res · February 1, 2019 BACKGROUND: Children with nonsyndromic orofacial clefts (NS OFCs) may require exceptional children's (EC) services for academic delays. We examined EC service use of children with and without NS OFCs in NC in elementary school. METHODS: We included 559 chi ... Full text Link to item Cite

Mutations in NCAPG2 Cause a Severe Neurodevelopmental Syndrome that Expands the Phenotypic Spectrum of Condensinopathies.

Journal Article Am J Hum Genet · January 3, 2019 The use of whole-exome and whole-genome sequencing has been a catalyst for a genotype-first approach to diagnostics. Under this paradigm, we have implemented systematic sequencing of neonates and young children with a suspected genetic disorder. Here, we r ... Full text Open Access Link to item Cite

Implementation of a Standardized Data-Collection System for Comprehensive Appraisal of Cleft Care.

Journal Article Cleft Palate Craniofac J · November 2018 OBJECTIVE: Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team. DESIGN: This is a single-arm implementation study in a single institution. SETTING: Implementation took place at a mid-sized ... Full text Link to item Cite

Socioeconomic Factors, Perioperative Complications, and 30-Day Readmission Rates Associated With Delayed Cranial Vault Reconstruction for Craniosynostosis.

Journal Article J Craniofac Surg · October 2018 BACKGROUND: Premature fusion of the cranial sutures can lead to significant neurocognitive, developmental, and esthetic consequences, especially if not corrected within the first year of life. This study aimed to identify the drivers of delayed cranial vau ... Full text Link to item Cite

Geospatial Analysis of Risk Factors Contributing to Loss to Follow-up in Cleft Lip/Palate Care.

Journal Article Plast Reconstr Surg Glob Open · September 2018 BACKGROUND: Multidisciplinary cleft care depends on follow-up at specified time points to monitor and address functional or aesthetic concerns that may arise during a child's development. However, loss to follow-up (LTFU) is common and can lead to missed o ... Full text Link to item Cite

Reliability of Oronasal Fistula Classification.

Journal Article Cleft Palate Craniofac J · July 2018 OBJECTIVE: Oronasal fistula is an important complication of cleft palate repair that is frequently used to evaluate surgical quality, yet reliability of fistula classification has never been examined. The objective of this study was to determine the reliab ... Full text Link to item Cite

Power-Assisted Particulate Bone Grafting Effectively Prevents Osseous Defects After Cranial Vault Reconstruction.

Journal Article J Craniofac Surg · May 2018 BACKGROUND: Cranial vault reconstruction (CVR) is the gold standard in the operative treatment of craniosynostosis. Full thickness osseous defects (FTOD) of the calvaria have been observed in 5% to 15% patients after CVR, with higher rates cited in the fro ... Full text Link to item Cite

Objective Assessment of the Unilateral Cleft Lip Nasal Deformity Using Three-Dimensional Stereophotogrammetry: Severity and Outcome.

Journal Article Plast Reconstr Surg · April 2018 BACKGROUND: Optimization of care to correct the unilateral cleft lip nasal deformity is hampered by lack of objective measures to quantify preoperative severity and outcome. The purpose of this study was to develop a consensus standard of nasal appearance ... Full text Link to item Cite

Academic Achievement Among Children With Nonsyndromic Orofacial Clefts : A Population-Based Study.

Journal Article Cleft Palate Craniofac J · January 2018 OBJECTIVE: Children with orofacial clefts (OFCs) may experience poor reading proficiency, learning disabilities, and academic underachievement. We examined the association between nonsyndromic (NS) OFCs and end-of-grade (EOG) performance in reading and mat ... Full text Link to item Cite

Epidemiologic Analysis of Elective Operative Procedures in Infants Less Than 6 Months of Age in the United States.

Journal Article Anesth Analg · November 2017 BACKGROUND: This study uses publicly available data to analyze the total number of elective, potentially deferrable operative procedures involving infants <6 months of age in the United States. We investigated the factors associated with the performance of ... Full text Link to item Cite

A Standard Set of Outcome Measures for the Comprehensive Appraisal of Cleft Care.

Journal Article Cleft Palate Craniofac J · September 2017 Care of the patient with cleft lip and/or palate remains complex. Prior attempts at aggregating data to study the effectiveness of specific interventions or overall treatment protocols have been hindered by a lack of data standards. There exists a critical ... Full text Link to item Cite

A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System.

Journal Article Plast Reconstr Surg Glob Open · September 2017 Establishing anatomic reduction of an edentulous mandible fracture is a frequently acknowledged challenge in craniomaxillofacial trauma surgery. In this study, we report a novel method for the reduction of the edentulous mandible fracture, via fabrication ... Full text Link to item Cite

Risk Factors for Delayed Referral to a Craniofacial Specialist for Treatment of Craniosynostosis.

Journal Article J Pediatr · July 2017 OBJECTIVE: To assess the impact of age at referral on treatment options in craniosynostosis and to identify risk factors for referral delays in this population. STUDY DESIGN: A retrospective cohort study was performed on patients with an abnormal head shap ... Full text Link to item Cite

Evidence-Based Medicine: Secondary Correction of Cleft Lip Nasal Deformity.

Journal Article Plast Reconstr Surg · July 2017 LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the components of unilateral and bilateral cleft lip nasal deformity. 2. Assess the deformity. 3. Design a treatment plan for secondary correction of cleft li ... Full text Link to item Cite

Post-Surgical Relapse in Metopic Synostosis and Limitations of the Interfrontal Angle as an Outcome Measure.

Journal Article J Craniofac Surg · July 2017 BACKGROUND: The interfrontal angle (IFA) has been utilized as a surrogate for morphologic assessment of the anterior cranial region in metopic synostosis with success in characterizing presenting severity. Its utility as an outcome measure has not been ass ... Full text Link to item Cite

A Population-Based Exploration of the Social Implications Associated with Cleft Lip and/or Palate.

Journal Article Plast Reconstr Surg Glob Open · June 2017 BACKGROUND: Clefts of the lip and/or palate (CL/P) carry a social stigma that often causes psychosocial stress. The purpose of this study was to consider the association of cleft phenotype and age with self-reported aspects of psychosocial stress. METHODS: ... Full text Link to item Cite

Classification of Cleft Lip/Palate: Then and Now.

Journal Article Cleft Palate Craniofac J · March 2017 Cleft lip and/or palate (CL/P) is phenotypically diverse, making classification difficult. This article explores the evolution of ideas regarding CL/P classification and includes the schemes described by Davis and Ritchie (1922) , Brophy (1923) , Veau (193 ... Full text Link to item Cite

Principles of Cleft Lip Repair: Conventions, Commonalities, and Controversies.

Journal Article Plast Reconstr Surg · March 2017 LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the principles of contemporary methods for repair of unilateral and bilateral cleft lip. 2. Understand the design elements of a poor repair that predispose to ... Full text Link to item Cite

Morbidity and healthcare costs of vascular anomalies: a national study.

Journal Article Pediatr Surg Int · February 2017 PURPOSE: This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies. METHODS: We reviewed the 2003-2009 Kids' Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangi ... Full text Link to item Cite

Clinician's Primer to ICD-10-CM Coding for Cleft Lip/Palate Care.

Journal Article Cleft Palate Craniofac J · January 2017 On October 1, 2015, the United States required use of the Clinical Modification of the International Classification of Diseases, 10th Revision (ICD-10-CM) for diagnostic coding. This primer was written to assist the cleft care community with understanding ... Full text Link to item Cite

Nasal Airway Dysfunction in Children with Cleft Lip and Cleft Palate: Results of a Cross-Sectional Population-Based Study, with Anatomical and Surgical Considerations.

Journal Article Plast Reconstr Surg · December 2016 BACKGROUND: The aesthetic aspects of the cleft lip nasal deformity have been appreciated for over a century, but the functional implications have remained largely underappreciated or misunderstood. This study describes the frequency and severity of nasal o ... Full text Link to item Cite

ICD-10-based expanded code set for use in cleft lip/palate research and surveillance.

Journal Article Birth Defects Res A Clin Mol Teratol · November 2016 BACKGROUND: On October 1, 2015, the United States required use of the Clinical Modification of the International Classification of Diseases, 10th Revision (ICD-10-CM) for diagnostic coding. The ICD-10-CM code set is limited to gross categories for cleft li ... Full text Link to item Cite

Laparoscopy Is Safe in Infants and Neonates with Congenital Heart Disease: A National Study of 3684 Patients.

Journal Article J Laparoendosc Adv Surg Tech A · October 2016 PURPOSE: Concerns have been raised about the use of laparoscopic surgery (LS) in infants with congenital heart disease (CHD) due to their unique physiology. Prior studies on the safety and effectiveness of laparoscopy in children with CHD are limited in sc ... Full text Link to item Cite

Design and validation of a dynamic cell-culture system for bone biology research and exogenous tissue-engineering applications.

Journal Article J Tissue Eng Regen Med · October 2016 Bone lacunocanalicular fluid flow ensures chemotransportation and provides a mechanical stimulus to cells. Traditional static cell-culture methods are ill-suited to study the intricacies of bone biology because they ignore the three-dimensionality of meani ... Full text Link to item Cite

Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis.

Journal Article Plast Reconstr Surg · May 2016 BACKGROUND: The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making. METHODS: An expert panel was asked to study 30 c ... Full text Link to item Cite

Facial Fractures in the Aging Population.

Journal Article Plast Reconstr Surg · February 2016 BACKGROUND: As the U.S. population ages and life expectancy increases, the number of elderly patients seeking trauma care and treatment for facial fractures will increase. Understanding age-related differences in the pattern, cause, and management of these ... Full text Link to item Cite

Hardware Removal in Craniomaxillofacial Trauma: A Systematic Review of the Literature and Management Algorithm.

Journal Article Ann Plast Surg · November 2015 BACKGROUND: Craniomaxillofacial (CMF) fractures are typically treated with open reduction and internal fixation. Open reduction and internal fixation can be complicated by hardware exposure or infection. The literature often does not differentiate between ... Full text Open Access Link to item Cite

Issues involved in the phenotypic classification of orofacial clefts ascertained through a state birth defects registry for the North Carolina Cleft Outcomes Study.

Journal Article Birth Defects Res A Clin Mol Teratol · November 2015 BACKGROUND: Epidemiologic studies involving birth defects are extremely sensitive to phenotype accuracy and precision. We devised a case review and classification protocol for a project to study school achievement in children with idiopathic, nonsyndromic ... Full text Link to item Cite

SCHOOL PERFORMANCE OF CHILDREN WITH OROFACIAL CLEFTS

Conference AMERICAN JOURNAL OF MEDICAL GENETICS PART A · August 1, 2015 Link to item Cite

Factors associated with high hospital resource use in a population-based study of children with orofacial clefts.

Journal Article Birth Defects Res A Clin Mol Teratol · February 2015 BACKGROUND: Little is known about population-based maternal, child, and system characteristics associated with high hospital resource use for children with orofacial clefts (OFC) in the US. METHODS: This was a statewide, population-based, retrospective obs ... Full text Link to item Cite

Hardware removal in craniomaxillofacial trauma a systematic review of the literature and management algorithm

Journal Article Annals of Plastic Surgery · January 1, 2015 Background: Craniomaxillofacial (CMF) fractures are typically treated with open reduction and internal fixation. Open reduction and internal fixation can be complicated by hardware exposure or infection. The literature often does not differentiate between ... Full text Cite

Video-assisted palatopharyngeal surgery: a model for improved education and training.

Journal Article Cleft Palate Craniofac J · September 2014 Objective : The learning process for intraoral procedures is arguably more difficult than for other surgical procedures because of the assistant's severely limited visibility. Consequently, trainees may not be able to adequately see and follow all steps of ... Full text Link to item Cite

Video-assisted palatopharyngeal surgery: a model for improved visualization, ergonomics, and education

Journal Article The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · September 1, 2014 Link to item Cite

Modern tenets for repair of bilateral cleft lip.

Journal Article Clin Plast Surg · April 2014 The understanding of the bilateral cleft lip and associated nasal deformity has evolved over the last 30 years to a point where there now exists general agreement regarding the goals, principles, and strategies for operative repair. This article presents m ... Full text Link to item Cite

Measuring outcomes in cleft lip and palate treatment.

Journal Article Clin Plast Surg · April 2014 Measuring meaningful outcomes in cleft lip and palate surgery is difficult. Many methods of measurement lack validity or reliability, are impractical to implement, or are not consistently used. Yet the power of measuring outcomes is so great, and the poten ... Full text Link to item Cite

Characterization of adipose-derived mesenchymal stem cell combinations for vascularized bone engineering.

Journal Article Tissue Eng Part A · June 2013 Since bone repair and regeneration depend on vasculogenesis and osteogenesis, both of these processes are essential for successful vascularized bone engineering. Using adipose-derived stem cells (ASCs), we investigated temporal gene expression profiles, as ... Full text Link to item Cite

Flow perfusion maintains ex vivo bone viability: a novel model for bone biology research.

Journal Article J Tissue Eng Regen Med · November 2012 Encased in lacunae, osteocytes receive nutrition and biomechanical signals through the lacunocanalicular system. We have developed a novel flow-perfusion bioreactor designed to support lacunocanalicular fluid flow. We hypothesize that ex vivo fluid flow ca ... Full text Link to item Cite

Factors associated with noncompliance with follow-up care after maxillofacial fractures

Conference Journal of the American College of Surgeons · September 2012 Full text Cite

Interfrontal angle for characterization of trigonocephaly: part 1: development and validation of a tool for diagnosis of metopic synostosis.

Journal Article J Craniofac Surg · May 2012 BACKGROUND: Surgical intervention for metopic synostosis is largely based on a subjective impression of the presence and severity of trigonocephaly. Several objective methods have been proposed to characterize phenotypic severity, but these methods are imp ... Full text Link to item Cite

A quantitative three-dimensional analysis of coronoid hypertrophy in pediatric craniofacial malformations.

Journal Article Plast Reconstr Surg · February 2012 BACKGROUND: Coronoid process hypertrophy can be associated with a variety of congenital or acquired anomalies. There is, however, no consensus on a quantitative or objective measure to define coronoid hypertrophy. Here, the authors describe a novel analyti ... Full text Link to item Cite

Progenitor cell mobilization enhances bone healing by means of improved neovascularization and osteogenesis.

Journal Article Plast Reconstr Surg · August 2011 BACKGROUND: Although bone repair is a relatively efficient process, a significant portion of patients fail to heal their fractures. Because adequate blood supply is essential to osteogenesis, the authors hypothesize that augmenting neovascularization by in ... Full text Link to item Cite

Current concepts in pediatric temporomandibular joint disorders: Part 1. Etiology, epidemiology, and classification.

Journal Article Plast Reconstr Surg · October 2010 BACKGROUND: Pediatric temporomandibular joint dysfunction, resulting from either soft-tissue or skeletal disorders, may be congenital or acquired. Congenital temporomandibular joint disorders are uncommon. The authors review their experience with pediatric ... Full text Link to item Cite

Delayed assessment and eager adoption of laparoscopic cholecystectomy: implications for developing surgical technologies.

Journal Article World J Gastroenterol · September 7, 2010 Despite the prevailing emphasis in the medical literature on establishing evidence, many changes in the practice of surgery have not been achieved using proper evidence-based assessment. This paper examines the adoption of laparoscopic cholecystectomy (LC) ... Full text Link to item Cite

Scaffold-based rhBMP-2 therapy in a rat alveolar defect model: implications for human gingivoperiosteoplasty.

Journal Article Plast Reconstr Surg · December 2009 BACKGROUND: Primary alveolar cleft repair has a 41 to 73 percent success rate. Patients with persistent alveolar defects require secondary bone grafting. The authors investigated scaffold-based therapies designed to augment the success of alveolar repair. ... Full text Link to item Cite

Periosteum-guided prefabrication of vascularized bone of clinical shape and volume.

Journal Article Plast Reconstr Surg · September 2009 BACKGROUND: Large craniofacial skeletal defects require complex reconstruction. Vascularized tissue transfer is the current standard in treatment, but these operations are technically difficult and associated with donor-site morbidity. Guided flap prefabri ... Full text Link to item Cite

Flow-perfusion coculture for vascularized bone engineering

Conference Journal of the American College of Surgeons · September 2009 Full text Cite

Establishment of a critical-sized alveolar defect in the rat: a model for human gingivoperiosteoplasty.

Journal Article Plast Reconstr Surg · March 2009 BACKGROUND: Despite technical advancement, treatment of congenital alveolar clefts has remained controversial. Currently, primary alveolar cleft repair (i.e., gingivoperiosteoplasty) has a 41 to 73 percent success rate. However, the remaining patients have ... Full text Link to item Cite

A novel flow-perfusion bioreactor supports 3D dynamic cell culture.

Journal Article J Biomed Biotechnol · 2009 BACKGROUND: Bone engineering requires thicker three-dimensional constructs than the maximum thickness supported by standard cell-culture techniques (2 mm). A flow-perfusion bioreactor was developed to provide chemotransportation to thick (6 mm) scaffolds. ... Full text Link to item Cite

Topical lineage-negative progenitor-cell therapy for diabetic wounds.

Journal Article Plast Reconstr Surg · November 2008 BACKGROUND: Impaired diabetic wound healing is due, in part, to defects in mesenchymal progenitor cell tracking. Theoretically, these defects may be overcome by administering purified progenitor cells directly to the diabetic wound. The authors hypothesize ... Full text Link to item Cite

Biological basis of bone formation, remodeling, and repair-part II: extracellular matrix.

Journal Article Tissue Eng Part B Rev · September 2008 The bony biochemical environment is a complex system that permits and promotes cellular functions that lead to matrix production and ossification. In Part I of this review, we discussed the important actions of signaling molecules, including hormones, cyto ... Full text Link to item Cite

Biological basis of bone formation, remodeling, and repair-part III: biomechanical forces.

Journal Article Tissue Eng Part B Rev · September 2008 While it has been long appreciated that biomechanical forces are involved in bone remodeling and repair, the actual mechanism by which a physical force is translated to the corresponding intracellular signal has largely remained a mystery. To date, most bi ... Full text Link to item Cite

Biological basis of bone formation, remodeling, and repair-part I: biochemical signaling molecules.

Journal Article Tissue Eng Part B Rev · September 2008 The bony biochemical environment is an active and dynamic system that permits and promotes cellular functions that lead to matrix production and ossification. Each component is capable of conveying important regulatory cues to nearby cells, thus effecting ... Full text Link to item Cite

Recreating the native bony environment in vitro

Conference Journal of the American College of Surgeons · September 2008 Full text Cite

Endogenous bone engineering using solid scaffolds with time-released porosity

Conference Journal of the American College of Surgeons · September 2008 Full text Cite

Dynamic cell culture for vascularized bone engineering

Conference Journal of the American College of Surgeons · September 2008 Full text Cite

Alveolar bone regeneration in a gingivoperiosteoplasty model

Conference TISSUE ENGINEERING PART A · May 1, 2008 Link to item Cite

Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer.

Journal Article Laryngoscope · January 2008 BACKGROUND: Radiation is a known risk factor for poor wound healing. Patients undergoing intraoperative radiation therapy (IORT) typically receive higher cumulative doses to their wound beds than patients treated with conventional radiation therapy. We rev ... Full text Link to item Cite

Comparison of guided bone formation from periosteum and muscle fascia.

Journal Article Plast Reconstr Surg · April 1, 2007 BACKGROUND: Muscle fascia and periosteum have been used clinically to guide prefabrication of vascularized bone flaps for reconstruction of complex three-dimensional tissues. Although it seems that both locations have the capacity to generate vascularized ... Full text Link to item Cite

Classification of pediatric TMJ disorders

Journal Article CRANIOFACIAL SURGERY: PROCEEDINGS OF THE TWELFTH INTERNATIONAL CONGRESS OF THE INTERNATIONAL SOCIETY OF CRANIOFACIAL SURGERY · January 1, 2007 Link to item Cite

Quantitative 3D-Analysis of pediatric coronoid process hypertrophy

Journal Article CRANIOFACIAL SURGERY: PROCEEDINGS OF THE TWELFTH INTERNATIONAL CONGRESS OF THE INTERNATIONAL SOCIETY OF CRANIOFACIAL SURGERY · January 1, 2007 Link to item Cite

Ovine model for engineering bone segments.

Journal Article Tissue Eng · 2005 We propose a large animal model for bone tissue engineering that yields quantitative data and simulates clinical methods and tissue needs. Skeletally mature domestic sheep (n = 20) were each implanted with three rectangular (1 x 1 x 4 cm), hollow tissue-mo ... Full text Link to item Cite