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New Advances in Cleft Lip and Palate and Facial Plastic Surgery

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 25 October 2026 | Viewed by 4275

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Special Issue Editors

Dr. Michael Schwaiger

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Guest Editor

1. Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
2. Department of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353 Berlin, Germany
Interests: cleft surgery; reconstructive surgery; cleft palate; rhinoplasty; orthognathic surgical procedures; orthognathic surgery; craniomaxillofacial surgery; maxillofacial surgery; facial plastic surgery; facial anomalies

Prof. Dr. Wolfgang Zemann

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Guest Editor

Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, Auenbruggerplatz 5, 8010 Graz, Austria
Interests: oral and maxillofacial surgery; medicine dentistry biochemistry; facial malformations; reconstructive surgery

Prof. Dr. Rainer Lutz

E-Mail Website
Guest Editor

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany
Interests: reconstructive surgery; cleft surgery; oral medicine; bone osseointegration; bone regeneration

Special Issue Information

Dear Colleagues,

Facial plastic and reconstructive surgical procedures, including the surgical treatment of cleft lip and palate, aim at achieving functional restoration and esthetic harmony. Despite significant progress in surgical techniques, deformities of the nasolabial region and nose remain challenging, often requiring complex staged interventions. Current research is increasingly directed toward understanding growth-related changes, optimizing surgical timing, and integrating advanced technologies such as three-dimensional imaging, virtual planning, patient-specific grafting, and regenerative tissue engineering.

This Special Issue of the Journal of Clinical Medicine aims to highlight translational and clinical advances in facial plastic surgery, with particular emphasis on the nasolabial complex and rhinoplasty. Contributions exploring long-term functional and esthetic outcomes, innovative surgical techniques, multidisciplinary treatment protocols, and patient-reported outcome measures are especially encouraged. By bridging research-driven innovation with clinical practice, this collection seeks to inform evidence-based strategies that improve both surgical precision and patient quality of life.

Dr. Michael Schwaiger
Prof. Dr. Wolfgang Zemann
Prof. Dr. Rainer Lutz
Guest Editors

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Keywords

cleft lip repair
rhinoplasty
secondary rhinoplasty
cleft rhinoplasty
facial plastic surgery
nasolabial area
upper lid surgery

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Research

17 pages, 2764 KB

Open AccessArticle

Artificial Intelligence in Rhinoplasty Recovery: Linguistic Intelligence and Machine Learning-Driven Insights

by Aynur Aliyeva, Elad Azizli, Vusala Snyder, Antiga Muradova, Natig Ahmadov, Togay Muderris, Ramil Hashimli, Selim S. Erbek, Sevinc Hepkarsi and Abdullah Dalgic

J. Clin. Med. 2026, 15(4), 1590; https://doi.org/10.3390/jcm15041590 - 18 Feb 2026

Viewed by 660

Abstract

Objective: This observational, cross-sectional simulation study evaluated ChatGPT-4 as a postoperative information tool for rhinoplasty using standardized questions and blinded ENT specialist ratings. Study Design: This study is an observational, cross-sectional simulation study using blinded expert evaluation. Setting: We used an online Artificial Intelligence (AI) platform accessed under standardized conditions. Methods: Ten typical recovery questions were posed to ChatGPT-4, and the responses were independently rated by ENT specialists for accuracy, clarity, relevance, response time, and patient-centered communication. Responses were also assessed with a structured performance instrument and supported by linguistic and statistical analyses. Results: ChatGPT-4 achieved high scores for accuracy (90%, 95% CI: 84.9–95.1) and clarity (87%, 95% CI: 82.8–91.2), but lower performance in patient-centered communication (77%, 95% CI: 74.0–80.0). Specialist scoring confirmed structured medical reasoning, while machine learning analyses highlighted clarity, diagnostic depth, and empathy as key contributors to higher ratings. Conclusions: ChatGPT-4 demonstrated high clinician-rated accuracy and clarity when answering standardized postoperative rhinoplasty questions, while patient-centered communication remained comparatively lower. These findings suggest that LLM-based tools may complement clinician-delivered postoperative counseling under appropriate oversight, but they are not a substitute for individualized medical advice or surgical follow-up. Full article

(This article belongs to the Special Issue New Advances in Cleft Lip and Palate and Facial Plastic Surgery)

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19 pages, 267 KB

Open AccessArticle

Reliability of Auditory-Perceptual Analysis in the Study of Speech Function in Patients with Unilateral Cleft and Palate

by Alexandra Bloeck, Nora Ann Doyle, Sylva Bartel and Michael Krimmel

J. Clin. Med. 2026, 15(2), 588; https://doi.org/10.3390/jcm15020588 - 12 Jan 2026

Viewed by 440

Abstract

Background/Objectives: Multidisciplinary outcome studies are carried out to evaluate long-term treatment in patients with cleft lip and palate. Speech function as one of the key outcomes of the treatment is examined by means of an auditory-perceptual analysis. For scientific and global studies it is essential to reduce the risk of bias as much as possible. The aim of the present study was the examination of auditory-perceptive analyses on the basis of an outcome study. Reliability was evaluated. Methods: Twenty patients were examined to evaluate their speech function. The speech sample was obtained via the online tool Zoom™. The speech sample consisted of single words (picture supported), a version of the German “Great Ormond Street Speech Assessment” (GOS.SP.ASS) sentences and spontaneous speech. The analysis was carried out by three experienced examiners, all using the German version of the Universal Reporting Parameters at two different times. The intrarater and interrater reliability were calculated. Results: Twenty participants with unilateral cleft and palate and a minimum age of 18 years (ø 20.1) were enrolled in the analysis of the speech function. None of the participants had undergone a secondary operation due to velopharyngeal incompetence. The examination happened at a point in time before an osteotomy might be needed. The multidisciplinary treatment of the 20 participants regarding their speech function was successful. There were only marginal abnormalities. The listeners showed a very good intrarater and moderate interrater reliability (ICC/Fleiss’ kappa). An overall percentual agreement of 88.3% was achieved. Conclusions: These positive results cannot be compared with outcome studies on a national or international level, since the construction of the speech sample as well as the structure and the implementation of the auditing process reveal considerable deficiencies in methodological rigor. The small number of examiners and patients as well as the patients’ minor residual impairments influence the significance of the statistical calculation by kappa and ICC. The auditory-perceptual analysis should be validated for German-speaking countries. Full article

(This article belongs to the Special Issue New Advances in Cleft Lip and Palate and Facial Plastic Surgery)

11 pages, 1512 KB

Open AccessArticle

Aesthetics Are in the Eye of the Beholder: Evaluation of the Nasolabial Appearance After Primary Cleft Lip Repair

by Michala Ivanic-Sefcikova, Vasco Starke, Marc Brommer, Lukas Groessing, Wolfgang Zemann, Carolin Bestendonk and Michael Schwaiger

J. Clin. Med. 2025, 14(21), 7501; https://doi.org/10.3390/jcm14217501 - 23 Oct 2025

Cited by 1 | Viewed by 870

Abstract

Background/Objectives: Primary cleft lip repair is a procedure to restore lip function and harmonious nasolabial appearance. However, the actual effects on nasolabial appearance have been insufficiently investigated. The aim of this study was therefore to critically review surgical results using well-validated objective and subjective methods and standardised outcome measures. Methods: A total of 26 non-syndromic patients with unilateral cleft lip +/− cleft palate were assessed retrospectively. Uniform 2D photographs of the nasolabial region were objectively analysed using SymNose software. The Cleft Aesthetic Rating Scale was employed for the subjective evaluation by a total of 255 observers with different backgrounds and experience levels in cleft surgery. Results: Significant positive correlation was identified between objective measurement of upper lip asymmetry and subjective assessment (p = 0.02). Furthermore, a significant difference emerged in the assessment of the nasolabial region depending on the rater’s professional background (p < 0.001). A major discrepancy was observed between the rating of maxillofacial consultants and those of laypersons and patients affected by cleft lip +/− cleft palate. Conclusions: The evaluation of attractiveness depends significantly on the professional background of the observer. The more interaction people have with individuals after cleft lip repair, the less they consider the aesthetics conspicuous. Achieving the highest possible postoperative nasolabial symmetry should be a main objective in primary cleft lip repair. Full article

(This article belongs to the Special Issue New Advances in Cleft Lip and Palate and Facial Plastic Surgery)

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