E-Poster
RP-0022
RP-0022
Digital Poster
Accepted E-Poster presentations from registered participants.
TOWARD PRECISION IN MANDIBULAR RECONSTRUCTION: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OF THREE-DIMENSIONAL VIRTUAL SURGICAL PLANNING VERSUS CONVENTIONAL PLANNING RP-0022
Albertus Andika Wongjaya · Research
Introduction:
Mandibular reconstruction remains a major challenge in craniofacial surgery because precise
restoration of mandibular anatomy is essential for both functional recovery and facial
symmetry. Conventional planning relies on two-dimensional imaging and intraoperative
freehand techniques, which may limit accurate reproduction of complex three-dimensional
anatomy. However, robust evidence demonstrating whether three-dimensional virtual surgical
planning (VSP) improves reconstruction accuracy and patient-perceived aesthetic outcomes
remains limited. Therefore, this study evaluated the effectiveness of VSP compared with
conventional planning in mandibular reconstruction.
Methods:
A systematic review and meta-analysis were conducted following the PRISMA guidelines.
Searches were performed in PubMed, Scopus, and Cochrane to identify studies comparing
VSP-assisted mandibular reconstruction with conventional surgical planning. Quantitative
outcomes related to postoperative accuracy and facial symmetry, including angular deviation,
gonial positional deviation, and condylar positional deviation, were analyzed in R software
(metafor package). Patient-reported aesthetic outcomes were summarized qualitatively.
Results:
A total of 15 studies were included in the final analysis. The outcomes were grouped into two
categories: quantitative reconstruction accuracy and patient-reported aesthetic outcomes. The
pooled analysis demonstrated significantly lower postoperative angular deviation in the VSP
group (MD −3.95°, 95% CI −5.69 to −2.21; I² = 82.4%). Similarly, VSP significantly reduced
gonial positional deviation (MD −3.22 mm, 95% CI −4.28 to −2.17, I2 = 68.7%) and condylar
positional deviation (MD −1.93 mm, 95% CI −3.31 to −0.55, I2 = 82.8%). Studies evaluating
patient-reported outcomes consistently demonstrated higher aesthetic satisfaction among
patients undergoing VSP-assisted reconstruction.
Conclusion:
Three-dimensional virtual surgical planning significantly improves the accuracy of mandibular
reconstruction and is associated with higher patient-reported aesthetic satisfaction. These
findings support the integration of three-dimensional virtual surgical planning technologies to
achieve more precise, predictable, and patient-centered outcomes in craniofacial reconstructive
surgery.
Mandibular reconstruction remains a major challenge in craniofacial surgery because precise
restoration of mandibular anatomy is essential for both functional recovery and facial
symmetry. Conventional planning relies on two-dimensional imaging and intraoperative
freehand techniques, which may limit accurate reproduction of complex three-dimensional
anatomy. However, robust evidence demonstrating whether three-dimensional virtual surgical
planning (VSP) improves reconstruction accuracy and patient-perceived aesthetic outcomes
remains limited. Therefore, this study evaluated the effectiveness of VSP compared with
conventional planning in mandibular reconstruction.
Methods:
A systematic review and meta-analysis were conducted following the PRISMA guidelines.
Searches were performed in PubMed, Scopus, and Cochrane to identify studies comparing
VSP-assisted mandibular reconstruction with conventional surgical planning. Quantitative
outcomes related to postoperative accuracy and facial symmetry, including angular deviation,
gonial positional deviation, and condylar positional deviation, were analyzed in R software
(metafor package). Patient-reported aesthetic outcomes were summarized qualitatively.
Results:
A total of 15 studies were included in the final analysis. The outcomes were grouped into two
categories: quantitative reconstruction accuracy and patient-reported aesthetic outcomes. The
pooled analysis demonstrated significantly lower postoperative angular deviation in the VSP
group (MD −3.95°, 95% CI −5.69 to −2.21; I² = 82.4%). Similarly, VSP significantly reduced
gonial positional deviation (MD −3.22 mm, 95% CI −4.28 to −2.17, I2 = 68.7%) and condylar
positional deviation (MD −1.93 mm, 95% CI −3.31 to −0.55, I2 = 82.8%). Studies evaluating
patient-reported outcomes consistently demonstrated higher aesthetic satisfaction among
patients undergoing VSP-assisted reconstruction.
Conclusion:
Three-dimensional virtual surgical planning significantly improves the accuracy of mandibular
reconstruction and is associated with higher patient-reported aesthetic satisfaction. These
findings support the integration of three-dimensional virtual surgical planning technologies to
achieve more precise, predictable, and patient-centered outcomes in craniofacial reconstructive
surgery.
E-Poster
CP-0018
CP-0018
- Title
- The Role of Postoperative Nasal Retainer in Achieving Nasal Symmetry after Modified Subunit Cheilonasorraphy: A Case Series
- Author(s)
- Faustine Emanuela
- Affiliation
- Pusat Angkatan Laut dr. Ramelan Hospital, Surabaya, Indonesia
The Role of Postoperative Nasal Retainer in Achieving Nasal Symmetry after Modified Subunit Cheilonasorraphy: A Case Series CP-0018
Faustine Emanuela · Case Report
Background: Postoperative nasal relapse — loss of alar symmetry and descent of the nasal tip — remains a common problem after primary repair of the cleft lip and nose, in both unilateral and bilateral forms. Postoperative nasal retainers and subunit-based lip closure have each been proposed to address this, but they are rarely reported together, and rarely across both cleft types in the same series.
Objective: To evaluate nasal symmetry and philtrum outcomes achieved by combining a modified subunit cheilonasorraphy — a combined lip-and-nose closure individually adapted to each patient's anatomy — with a postoperative nasal retainer, in patients with unilateral and bilateral cleft lip and nose.
Methods: This is a case series of 6 patients with unilateral an bilateral cleft lip who underwent primary cheilonasorraphy using a modified subunit technique. All patients received a postoperative nasal retainer for 30 days. Outcomes were assessed using clinical image and physician’s clinical evaluation over a follow-up period of January to May 2026.
Result: All six patients showed a rounded, symmetic alar shape without nasal-tip flattening, and the lip philtrum remained well defined postoperatively. No infection, no dehiscence , minimum septum deviation and hypertrophic scar occurred were observed.
Conclusion: Combining a modified-subunit cheilonasorraphy technique with postoperative nasal retainer appears promising for perserving nasal shape and philtrum contour in primary repair to unilateral and bilateral cleft lip. Controlled comparative studies with larger samples and objective measurements are needed to confirm the advantage of this technique over conventional approaches.
Objective: To evaluate nasal symmetry and philtrum outcomes achieved by combining a modified subunit cheilonasorraphy — a combined lip-and-nose closure individually adapted to each patient's anatomy — with a postoperative nasal retainer, in patients with unilateral and bilateral cleft lip and nose.
Methods: This is a case series of 6 patients with unilateral an bilateral cleft lip who underwent primary cheilonasorraphy using a modified subunit technique. All patients received a postoperative nasal retainer for 30 days. Outcomes were assessed using clinical image and physician’s clinical evaluation over a follow-up period of January to May 2026.
Result: All six patients showed a rounded, symmetic alar shape without nasal-tip flattening, and the lip philtrum remained well defined postoperatively. No infection, no dehiscence , minimum septum deviation and hypertrophic scar occurred were observed.
Conclusion: Combining a modified-subunit cheilonasorraphy technique with postoperative nasal retainer appears promising for perserving nasal shape and philtrum contour in primary repair to unilateral and bilateral cleft lip. Controlled comparative studies with larger samples and objective measurements are needed to confirm the advantage of this technique over conventional approaches.
E-Poster
CP-0017
CP-0017
- Title
- When the Eyelids Heal Toghether: Two-Lamellar Reconstruction of a Rare Post-Traumatic Medial Canthal Ankyloblepharon
- Author(s)
- Faustine Emanuela
- Affiliation
- Pusat Angkatan Laut Dr. Ramelan Hospital, Surabaya, Indonesia
When the Eyelids Heal Toghether: Two-Lamellar Reconstruction of a Rare Post-Traumatic Medial Canthal Ankyloblepharon CP-0017
Faustine Emanuela · Case Report
Purpose: Post-traumatic medial canthal ankyloblepharon is an uncommon acquired cicatricial eyelid deformity that can result in severe eyelid contracture, visual obstruction, and functional impairment. When both anterior and posterior lamellar tissues are inivolved, simple adhesiolysis may be insufficient and may predispose to recurrent contracture. We present a two -lamellar reconstrucitve strategy combining complete synechial release, sequential Z-plasty, and vascularized iniferior palpebral conjungtival tissue.
Methods: A 66-year-old man presented with a unilateral left medial canthal eyelid deformity approximately one year following a motor vehicle accident. The upper and lower eyelids were cicatrically fused from the medial canthus toward the central one-third orf the eyelid, resulting in restricted eyelid opening and visual impairment. Intraoperative exploration demonstrated dense cicatricial synechiae with contracture involving both the superior and inferior eyelids and disruption of the anterior and posterior lamellar architecture. Complete synechial release was performed. Multiple z-plasties were designed on the superior/anterior lamella to reorient the scar and provide tissue lengthening. Inferior eyelid contracture was release through a lower blepharoplasty-type approach. The resulting posterior lamellar defect was reconstructed using an inferior palpebral conjunctival wedge flap. Providing vascularized native tissue coverage.
Result: The procedure restored separation of the upper and lower eyelids re-established the medial canthal architecture. Postoperatively, the patient achieved eyelid opening comparable to the contralateral eye with satisfactory eyelid closure. No wound infection or dehiscence occurred. The patient reported satisfactory functional and aesthetic improvement with a marked improvement in quality of life.
Conclusion: Post-traumatic medial canthal ankyloblepharon should be considered a complex three-dimensional cicatricial deformity rather than a simple eyelid adhesion. Successful reconstruction requires simultaneous correction of the contractile forces and restoration of the ephitelialized surfaces of both eyelid lamellae. The combiniation of synechial release, Z-plasty-based anterior lamellar lengthening, and vascularized conjunctival resurfacing provides a tissue-perservinig release-reorient-resurface stratefy for restoring eyelid separation and function.
Methods: A 66-year-old man presented with a unilateral left medial canthal eyelid deformity approximately one year following a motor vehicle accident. The upper and lower eyelids were cicatrically fused from the medial canthus toward the central one-third orf the eyelid, resulting in restricted eyelid opening and visual impairment. Intraoperative exploration demonstrated dense cicatricial synechiae with contracture involving both the superior and inferior eyelids and disruption of the anterior and posterior lamellar architecture. Complete synechial release was performed. Multiple z-plasties were designed on the superior/anterior lamella to reorient the scar and provide tissue lengthening. Inferior eyelid contracture was release through a lower blepharoplasty-type approach. The resulting posterior lamellar defect was reconstructed using an inferior palpebral conjunctival wedge flap. Providing vascularized native tissue coverage.
Result: The procedure restored separation of the upper and lower eyelids re-established the medial canthal architecture. Postoperatively, the patient achieved eyelid opening comparable to the contralateral eye with satisfactory eyelid closure. No wound infection or dehiscence occurred. The patient reported satisfactory functional and aesthetic improvement with a marked improvement in quality of life.
Conclusion: Post-traumatic medial canthal ankyloblepharon should be considered a complex three-dimensional cicatricial deformity rather than a simple eyelid adhesion. Successful reconstruction requires simultaneous correction of the contractile forces and restoration of the ephitelialized surfaces of both eyelid lamellae. The combiniation of synechial release, Z-plasty-based anterior lamellar lengthening, and vascularized conjunctival resurfacing provides a tissue-perservinig release-reorient-resurface stratefy for restoring eyelid separation and function.
E-Poster
CP-0013
CP-0013
- Title
- Long-term Speech and Resonance Outcomes of Children with Unilateral Cleft Lip and Palate Born During the COVID-19 Pandemic: A Case Series from Northeast Thailand
- Author(s)
- Natthasart Unasri
- Affiliation
- Khon Kaen Hospital, Khon Kaen, Thailand
Long-term Speech and Resonance Outcomes of Children with Unilateral Cleft Lip and Palate Born During the COVID-19 Pandemic: A Case Series from Northeast Thailand CP-0013
Natthasart Unasri · Case Report
Background: COVID-19 disruptions delayed cleft surgeries and therapy. Long-term speech outcomes of pandemic-born cohorts remain underreported.
Objectives: To compare 2026 speech, resonance, and oral-motor outcomes of three pediatric patients with Left Unilateral Cleft Lip and Palate (UCLP) managed during 2020–2022 at Khon Kaen Hospital.
Methods: Retrospective tracking of three children (aged 5–6 years). Perceptual speech, resonance, and oral-motor function (Range of Motion; ROM) were evaluated alongside clinical timelines and complications.
Results: Outcomes in 2026 were highly heterogeneous:
Case 1 (High therapy adherence): Achieved competent sentence production, Mild articulation impairment, Fair intelligibility, and normal resonance (Hypernasality: 0, Nasal Emission: 0).
Case 2 (Late-onset hearing loss): Showed Moderate articulation impairment, Poor intelligibility, and mild resonance deficits (+1).
Case 3 (Surgical delay + oronasal fistula): Displayed restricted language (words/phrases), Severe articulation impairment, Poor intelligibility, resolved hypernasality (0), but persistent nasal emission (+1).
All cases showed "Adequate / Partial ROM".
Conclusion: Pandemic disruptions severely impacted long-term speech outcomes, heavily dictated by surgical timing, therapy compliance, fistulas, and hearing barriers. Targeted interventions are crucial to bridge these pandemic-induced care gaps.
Objectives: To compare 2026 speech, resonance, and oral-motor outcomes of three pediatric patients with Left Unilateral Cleft Lip and Palate (UCLP) managed during 2020–2022 at Khon Kaen Hospital.
Methods: Retrospective tracking of three children (aged 5–6 years). Perceptual speech, resonance, and oral-motor function (Range of Motion; ROM) were evaluated alongside clinical timelines and complications.
Results: Outcomes in 2026 were highly heterogeneous:
Case 1 (High therapy adherence): Achieved competent sentence production, Mild articulation impairment, Fair intelligibility, and normal resonance (Hypernasality: 0, Nasal Emission: 0).
Case 2 (Late-onset hearing loss): Showed Moderate articulation impairment, Poor intelligibility, and mild resonance deficits (+1).
Case 3 (Surgical delay + oronasal fistula): Displayed restricted language (words/phrases), Severe articulation impairment, Poor intelligibility, resolved hypernasality (0), but persistent nasal emission (+1).
All cases showed "Adequate / Partial ROM".
Conclusion: Pandemic disruptions severely impacted long-term speech outcomes, heavily dictated by surgical timing, therapy compliance, fistulas, and hearing barriers. Targeted interventions are crucial to bridge these pandemic-induced care gaps.
E-Poster
RP-0017
RP-0017
- Title
- Healthcare Access to Cleft Care in Southeast Asia: A Scoping Review of Barriers and Facilitators
- Author(s)
- Chloe Shada Nareswari
- Affiliation
- Universitas Indonesia
Healthcare Access to Cleft Care in Southeast Asia: A Scoping Review of Barriers and Facilitators RP-0017
Chloe Shada Nareswari · Research
Introduction: Cleft lip and palate (CL/P) requires timely, long-term multidisciplinary care to optimize functional and psychosocial outcomes. Southeast Asia faces substantial disparities in healthcare resources and geographic access, yet evidence on cleft care accessibility across the region remains fragmented. This scoping review mapped barriers and facilitators influencing access to cleft care in Southeast Asia.
Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR. A comprehensive search of PubMed, CENTRAL, Scopus, and Wiley Online Library was performed using controlled vocabulary (MeSH where applicable), free-text terms, synonyms, and related terms for CL/P, healthcare access, and Southeast Asian countries. Study selection was conducted in Covidence according to predefined eligibility criteria. Data were charted and synthesized using thematic analysis.
Results: Sixty-four studies were included. Five categories of barriers were identified: financial (travel costs, low socioeconomic status), geographic (long travel distance), health system (challenging referral procedures, prolonged surgical waiting times, inadequate facilities, absence of a follow-up reminder system), workforce (limited trained medical personnel), and information, communication, and health literacy (limited knowledge of available cleft services, language barriers, low health literacy, limited communication skills). Facilitators were grouped into five domains: health information and patient education (social media, guidebooks, translated CLEFT-Q/assessment tools, specialist and peer advice), care coordination and service delivery innovations (telemedicine, community-based speech therapy, speech camps, treatment scheduling method, integrated care and referral systems), workplace capacity building (training programs), health system strengthening (registries, geographic information systems, information and communication technology, healthcare networks), and community and organizational support (NGOs, volunteer mission teams, healthcare insurance).
Conclusion: Access to cleft care in Southeast Asia remains limited by multiple barriers. Improving outcomes requires context-specific strategies, stronger health systems, and regional collaboration. Future research should address psychosocial factors, cultural beliefs, and patient and family perspectives.
Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR. A comprehensive search of PubMed, CENTRAL, Scopus, and Wiley Online Library was performed using controlled vocabulary (MeSH where applicable), free-text terms, synonyms, and related terms for CL/P, healthcare access, and Southeast Asian countries. Study selection was conducted in Covidence according to predefined eligibility criteria. Data were charted and synthesized using thematic analysis.
Results: Sixty-four studies were included. Five categories of barriers were identified: financial (travel costs, low socioeconomic status), geographic (long travel distance), health system (challenging referral procedures, prolonged surgical waiting times, inadequate facilities, absence of a follow-up reminder system), workforce (limited trained medical personnel), and information, communication, and health literacy (limited knowledge of available cleft services, language barriers, low health literacy, limited communication skills). Facilitators were grouped into five domains: health information and patient education (social media, guidebooks, translated CLEFT-Q/assessment tools, specialist and peer advice), care coordination and service delivery innovations (telemedicine, community-based speech therapy, speech camps, treatment scheduling method, integrated care and referral systems), workplace capacity building (training programs), health system strengthening (registries, geographic information systems, information and communication technology, healthcare networks), and community and organizational support (NGOs, volunteer mission teams, healthcare insurance).
Conclusion: Access to cleft care in Southeast Asia remains limited by multiple barriers. Improving outcomes requires context-specific strategies, stronger health systems, and regional collaboration. Future research should address psychosocial factors, cultural beliefs, and patient and family perspectives.
E-Poster
RP-0020
RP-0020
- Title
- Treatment Outcomes of Comprehensive Care in Patients with Cleft Lip and Palate and Congenital Craniofacial Anomalies: A Retrospective Study
- Author(s)
- Yupin Paggasang
- Affiliation
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
Treatment Outcomes of Comprehensive Care in Patients with Cleft Lip and Palate and Congenital Craniofacial Anomalies: A Retrospective Study RP-0020
Yupin Paggasang · Research
Background and Objectives: Comprehensive care for patients with cleft lip and palate (CLP) and Congenital Craniofacial Anomalies is essential for long-term outcomes. Evaluation of treatment outcomes is therefore necessary to support the improvement of healthcare service systems.
Methods: This retrospective descriptive study collected data from medical records, operative reports, and hospital information systems from 1968 to 2025. A total of 72 patients were included. Data were recorded using a two-part form: general information and five domains of comprehensive care (health, education, social, livelihood, and empowerment). Data were analyzed using descriptive statistics.
Results: Most patients were female and in adolescence, with unilateral CLP being the most common diagnosis. In the health domain, most patients had undergone primary lip repair and were in the follow-up phase of treatment. In the education domain, the majority continued their education according to age (81.95%). In the social domain, most patients reported no limitations in social participation (91.66%). In the livelihood domain, more than half remained dependent on their families (58.34%). In the empowerment domain, all patients received support and were involved in their care. However, access to rehabilitation services, such as speech therapy and hearing assessment, was not fully covered.
Conclusion: Patients with CLP represent a complex group requiring long-term multidisciplinary care. Although educational and social outcomes were generally favorable, limitations remain in terms of dependency and access to rehabilitation services. These areas should be further developed to improve long-term quality of life.
Methods: This retrospective descriptive study collected data from medical records, operative reports, and hospital information systems from 1968 to 2025. A total of 72 patients were included. Data were recorded using a two-part form: general information and five domains of comprehensive care (health, education, social, livelihood, and empowerment). Data were analyzed using descriptive statistics.
Results: Most patients were female and in adolescence, with unilateral CLP being the most common diagnosis. In the health domain, most patients had undergone primary lip repair and were in the follow-up phase of treatment. In the education domain, the majority continued their education according to age (81.95%). In the social domain, most patients reported no limitations in social participation (91.66%). In the livelihood domain, more than half remained dependent on their families (58.34%). In the empowerment domain, all patients received support and were involved in their care. However, access to rehabilitation services, such as speech therapy and hearing assessment, was not fully covered.
Conclusion: Patients with CLP represent a complex group requiring long-term multidisciplinary care. Although educational and social outcomes were generally favorable, limitations remain in terms of dependency and access to rehabilitation services. These areas should be further developed to improve long-term quality of life.
E-Poster
RO-0078
RO-0078
- Title
- Robust assessment based on unreliable measurements: Construction and testing of an experimental device for the assessment of oral-nasal balance
- Author(s)
- Yifei CHEN
- Affiliation
- Department of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto
Robust assessment based on unreliable measurements: Construction and testing of an experimental device for the assessment of oral-nasal balance RO-0078
Yifei CHEN · Research
Cécile Yifei Chen, Zhaohua Zhang, Somayah Al-Ees, Sarah Bodenbach, Tim Bressmann
Department of Speech-Language Pathology, Temerty Medicine, University of Toronto
Introduction: Nasometry is an important tool for quantifying oral-nasal balance in children with cleft palate. However, the Nasometer is expensive and not available to clinicians in resource-limited settings. Designs for alternative low-cost devices have been published, yet different devices may produce different mean scores, limiting between-device comparability and diagnostic cutoffs. Experimental “Nasophone” devices were built from readily available materials. Mean nasalance scores as well as derived relative measures (including speech tasks with nose-pinching) were compared.
Methods: The balance of eight electret microphone pairs was quantified on a test bench with multi-speaker babble stereo panoramas. Experimental nasalance measurements were made by rerecording nasal, mixed and non-nasal sentences spoken by 10 typical speakers (8 females), who produced normal speech as well as simulations of hypernasality, hyponasality and mixed nasality. Nasalance distance, ratio, and two new composite measures were calculated.
Results: Across the eight microphone pairs, the mean difference in nasalance scores for the babble panoramas was 1.18 (SD = 0.72), with 96.3% falling within 2 nasalance points. For the re-recorded sentences, the mean difference in nasalance scores between the microphone pairs was 3.75 (SD = 3.1), with 85% falling within 6 nasalance points. For the nose-pinch condition, the mean difference was 5.34 (SD = 3.3), with 80% falling within 6 nasalance points. Using a combination of the nasalance distance, ratio, and two composite measures, a linear discriminant analysis demonstrated a mean classification accuracy of 77%, based on 128 test samples from 8 speakers.
Conclusion: Different microphone pairs may return different nasalance scores. Using relative rather than mean-based nasalance measures may reduce the effect of device-specific microphone balances and support diagnostic differentiation across different devices. Further testing with clinical data is required.
Department of Speech-Language Pathology, Temerty Medicine, University of Toronto
Introduction: Nasometry is an important tool for quantifying oral-nasal balance in children with cleft palate. However, the Nasometer is expensive and not available to clinicians in resource-limited settings. Designs for alternative low-cost devices have been published, yet different devices may produce different mean scores, limiting between-device comparability and diagnostic cutoffs. Experimental “Nasophone” devices were built from readily available materials. Mean nasalance scores as well as derived relative measures (including speech tasks with nose-pinching) were compared.
Methods: The balance of eight electret microphone pairs was quantified on a test bench with multi-speaker babble stereo panoramas. Experimental nasalance measurements were made by rerecording nasal, mixed and non-nasal sentences spoken by 10 typical speakers (8 females), who produced normal speech as well as simulations of hypernasality, hyponasality and mixed nasality. Nasalance distance, ratio, and two new composite measures were calculated.
Results: Across the eight microphone pairs, the mean difference in nasalance scores for the babble panoramas was 1.18 (SD = 0.72), with 96.3% falling within 2 nasalance points. For the re-recorded sentences, the mean difference in nasalance scores between the microphone pairs was 3.75 (SD = 3.1), with 85% falling within 6 nasalance points. For the nose-pinch condition, the mean difference was 5.34 (SD = 3.3), with 80% falling within 6 nasalance points. Using a combination of the nasalance distance, ratio, and two composite measures, a linear discriminant analysis demonstrated a mean classification accuracy of 77%, based on 128 test samples from 8 speakers.
Conclusion: Different microphone pairs may return different nasalance scores. Using relative rather than mean-based nasalance measures may reduce the effect of device-specific microphone balances and support diagnostic differentiation across different devices. Further testing with clinical data is required.
E-Poster
RO-0077
RO-0077
- Title
- Cross-Linguistic Nasalance Profiles in Healthy Malaysian Adults: A Comparison Across Malay, Mandarin, and Tamil
- Author(s)
- Hasherah Mohd Ibrahim
- Affiliation
- UNIVERSITI KEBANSAAN MALAYSIA
Cross-Linguistic Nasalance Profiles in Healthy Malaysian Adults: A Comparison Across Malay, Mandarin, and Tamil RO-0077
Hasherah Mohd Ibrahim · Research
Introduction: Nasalance is an objective acoustic measure of the ratio of nasal to total acoustic energy during speech, used clinically to assess hypernasality and hyponasality. Nasalance values vary across languages and phonetic content, yet Malaysia lacks population-specific norms for Malay-, Mandarin-, and Tamil-speaking adults, and clinicians rely on foreign, pediatric, or mismatched benchmarks. This study compared nasalance profiles across these three major Malaysian language communities using harmonized stimuli and identical instrumentation to determine whether language-specific norms are clinically warranted.
Materials & Methods: A total of 116 healthy adults participated: 42 Malay speakers (14 males, 28 females; aged 19 to 35 years), 43 Mandarin speakers (20 males, 23 females; aged 19 to 25 years), and 31 Tamil speakers (5 males, 26 females; aged 18 to 36 years). Each participant read an oral passage, a nasal passage, and a set of oronasal phoneme-loaded sentences developed and validated in their respective language. Nasalance was recorded using the Nasometer II (KayPENTAX, Model 6500). Kruskal-Wallis tests with Dunn's post-hoc comparisons (Bonferroni-corrected) examined between-language differences for each passage type; Mann-Whitney U and independent samples t-tests examined gender differences within each language.
Results: Significant between-language differences were found for the oral passage (H=21.87, p<0.001), nasal passage (H=8.08, p=0.018), and oronasal sentences (H=24.04, p<0.001). Mandarin speakers produced significantly lower oral passage nasalance than Malay and Tamil speakers (p<0.001, p=0.017). Malay speakers showed significantly higher nasal passage scores than Tamil speakers (p=0.014), and significantly lower oronasal scores than Mandarin (p=0.017) and Tamil (p<0.001) speakers. No gender differences were found within any language group (p>0.05).
Conclusion: Nasalance profiles differ significantly across Malay, Mandarin, and Tamil speakers even when instrumentation, protocol, and stimulus construction are held constant within one country. Language-specific normative data are therefore clinically necessary in Malaysia's multilingual healthcare setting, and norms should not be generalized across language communities.
Materials & Methods: A total of 116 healthy adults participated: 42 Malay speakers (14 males, 28 females; aged 19 to 35 years), 43 Mandarin speakers (20 males, 23 females; aged 19 to 25 years), and 31 Tamil speakers (5 males, 26 females; aged 18 to 36 years). Each participant read an oral passage, a nasal passage, and a set of oronasal phoneme-loaded sentences developed and validated in their respective language. Nasalance was recorded using the Nasometer II (KayPENTAX, Model 6500). Kruskal-Wallis tests with Dunn's post-hoc comparisons (Bonferroni-corrected) examined between-language differences for each passage type; Mann-Whitney U and independent samples t-tests examined gender differences within each language.
Results: Significant between-language differences were found for the oral passage (H=21.87, p<0.001), nasal passage (H=8.08, p=0.018), and oronasal sentences (H=24.04, p<0.001). Mandarin speakers produced significantly lower oral passage nasalance than Malay and Tamil speakers (p<0.001, p=0.017). Malay speakers showed significantly higher nasal passage scores than Tamil speakers (p=0.014), and significantly lower oronasal scores than Mandarin (p=0.017) and Tamil (p<0.001) speakers. No gender differences were found within any language group (p>0.05).
Conclusion: Nasalance profiles differ significantly across Malay, Mandarin, and Tamil speakers even when instrumentation, protocol, and stimulus construction are held constant within one country. Language-specific normative data are therefore clinically necessary in Malaysia's multilingual healthcare setting, and norms should not be generalized across language communities.
E-Poster
RP-0008
RP-0008
- Title
- A Standardized Clinical Protocol for Digital Nasal Stents in Patients with Cleft Lip and Palate
- Author(s)
- Pitchaporn Teacharushatakit
- Affiliation
- Khon Kaen University
A Standardized Clinical Protocol for Digital Nasal Stents in Patients with Cleft Lip and Palate RP-0008
Pitchaporn Teacharushatakit · Research
Introduction: Presurgical nasoalveolar molding (NAM) restores nasal symmetry, lengthens the columella, and aligns displaced nasolabial tissues in infants with cleft lip and/or palate (CL/P) prior to primary cheiloplasty. However, traditional manual techniques remain labor-intensive and prone to clinical variability. Advances in computer-aided design and computer-aided manufacturing (CAD/CAM) have facilitated the development of 3D-printed Digital Nasal Stents (DNS) and Digital Nasal Stents with Lip Band (DNSLB). Developed at the Faculty of Dentistry, Khon Kaen University, these appliances offer a standardized, digitally driven alternative to conventional techniques. This report describes a systematic, step-by-step clinical protocol for presurgical nasal molding and postoperative retention using the DNS/DNSLB system.
Methods: Using CAD/CAM technology, two primary 3D-printed appliance series were fabricated: Digital Nasal Stents (DNS) and Digital Nasal Stents with Lip Band (DNSLB), available in three progressive sizes (Newborn, Standard, and Overcorrection). A four-phase clinical protocol was established for sequential presurgical molding and postoperative retention. Treatment initiated at first consultation with the DNS Newborn, combined with lip strapping as needed. At 1–2 weeks, patients transitioned to the DNS Standard alongside an active or passive intraoral plate. Targeted nasal molding was enhanced using the DNSLB Standard before advancing to DNSLB Overcorrection until primary cheiloplasty. Postoperatively (1–2 weeks post-op), appliance sizing was "stepped down" to a DNS Newborn or Standard to mitigate scar contracture and preserve nasal form during healing.
Results: Clinical implementation of the protocol provided a structured, predictable workflow for correcting cleft nasal deformities. Sequential size progression successfully guided alar molding and columellar lengthening presurgically, while postoperative size step-down minimized scar contracture and maintained nasal symmetry throughout healing.
Conclusion: The Khon Kaen University DNS/DNSLB protocol establishes a systematic, digitally driven approach to presurgical nasal molding and postoperative retention. By replacing manual modifications with standardized CAD/CAM progressions, this protocol offers a practical, highly reproducible clinical solution.
Methods: Using CAD/CAM technology, two primary 3D-printed appliance series were fabricated: Digital Nasal Stents (DNS) and Digital Nasal Stents with Lip Band (DNSLB), available in three progressive sizes (Newborn, Standard, and Overcorrection). A four-phase clinical protocol was established for sequential presurgical molding and postoperative retention. Treatment initiated at first consultation with the DNS Newborn, combined with lip strapping as needed. At 1–2 weeks, patients transitioned to the DNS Standard alongside an active or passive intraoral plate. Targeted nasal molding was enhanced using the DNSLB Standard before advancing to DNSLB Overcorrection until primary cheiloplasty. Postoperatively (1–2 weeks post-op), appliance sizing was "stepped down" to a DNS Newborn or Standard to mitigate scar contracture and preserve nasal form during healing.
Results: Clinical implementation of the protocol provided a structured, predictable workflow for correcting cleft nasal deformities. Sequential size progression successfully guided alar molding and columellar lengthening presurgically, while postoperative size step-down minimized scar contracture and maintained nasal symmetry throughout healing.
Conclusion: The Khon Kaen University DNS/DNSLB protocol establishes a systematic, digitally driven approach to presurgical nasal molding and postoperative retention. By replacing manual modifications with standardized CAD/CAM progressions, this protocol offers a practical, highly reproducible clinical solution.
E-Poster
CP-0004
CP-0004
- Title
- Pre-Surgical Infant Orthopedic with Digital Nasal Stents and Sequential Alveolar Aligners in Unilateral Complete Cleft Lip and Palate: A Case Report
- Author(s)
- Pornpat Butpun
- Affiliation
- Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
Pre-Surgical Infant Orthopedic with Digital Nasal Stents and Sequential Alveolar Aligners in Unilateral Complete Cleft Lip and Palate: A Case Report CP-0004
Pornpat Butpun · Case Report
Introduction: Digital workflows and 3-dimensional (3D) printing have modernized presurgical infant orthopedics. The Digital Nasal Stents (DNS), developed and patented under the Faculty of Dentistry, Khon Kaen University, offers prefabricated, standardized nasal retainers for correcting cleft nose deformities. Complementing this, the AccuCleft system employs proprietary software to design sequential 3D-printed intraoral plates that accommodate maxillary growth, providing an efficient solution for large alveolar gaps (>12 mm) or patients with limited appointment availability.
Methods: This case report presents a fully digital nasoalveolar molding (NAM) protocol utilizing DNS in conjunction with AccuCleft in an infant with complete unilateral cleft lip and palate (UCLP). A 3-day-old male with complete UCLP presented for presurgical management. Intraoral impressions and nasal scans were first obtained digitally using Dexis™. The resulting stereolithography (STL) files were then imported into AccuCleft software to generate a series of virtual models and corresponding stage-specific plates. Both DNS and AccuCleft appliances were fabricated using a 3D printer (Form 3B, Formlabs) with a biocompatible resin (Dental LT Clear V2).
Results: Over 140 days, following 4 DNS adjustments and 7 sequential alveolar aligner stages, the alveolar cleft gap was successfully reduced from 12 mm to 0 mm, alongside significant improvements in nasal symmetry and nostril morphology prior to primary cheiloplasty.
Conclusion: Integrating 3D-printed DNS and AccuCleft appliances into a digital NAM workflow effectively eliminated the alveolar cleft gap and enhanced nasal symmetry within a 140-day treatment window, confirming the feasibility of fully digital workflows in presurgical infant orthopedics management.
Methods: This case report presents a fully digital nasoalveolar molding (NAM) protocol utilizing DNS in conjunction with AccuCleft in an infant with complete unilateral cleft lip and palate (UCLP). A 3-day-old male with complete UCLP presented for presurgical management. Intraoral impressions and nasal scans were first obtained digitally using Dexis™. The resulting stereolithography (STL) files were then imported into AccuCleft software to generate a series of virtual models and corresponding stage-specific plates. Both DNS and AccuCleft appliances were fabricated using a 3D printer (Form 3B, Formlabs) with a biocompatible resin (Dental LT Clear V2).
Results: Over 140 days, following 4 DNS adjustments and 7 sequential alveolar aligner stages, the alveolar cleft gap was successfully reduced from 12 mm to 0 mm, alongside significant improvements in nasal symmetry and nostril morphology prior to primary cheiloplasty.
Conclusion: Integrating 3D-printed DNS and AccuCleft appliances into a digital NAM workflow effectively eliminated the alveolar cleft gap and enhanced nasal symmetry within a 140-day treatment window, confirming the feasibility of fully digital workflows in presurgical infant orthopedics management.
E-Poster
RP-0010
RP-0010
- Title
- An analysis of mandibular characteristics according to biological sex using 3D CT scans in Koreans
- Author(s)
- Soyeon Jung
- Affiliation
- Hallym University Dongtan Sacred Heart Hospital
An analysis of mandibular characteristics according to biological sex using 3D CT scans in Koreans RP-0010
Soyeon Jung · Research
Introduction: With the increasing demand for facial feminization surgery (FFS), precise knowledge of sex-based andibular morphology has become clinically relevant. In this study, “male” and “female” refer to biological sex as recorded in medical records; gender identity was not assessed. We aimed to analyze sex differences in mandibular morphology using three-dimensional (3D) computed tomography (CT) in a Korean population and to provide anatomic data applicable to mandibular contouring in FFS.
Methods: A retrospective analysis was conducted on 275 Korean patients who underwent facial CT between 2017 and 2019. Three- dimensional cephalometric analysis was performed to evaluate angular, linear, and transverse mandibular parameters, as well as non-metric features including chin shape and inferior mandibular border contour. Statistical comparisons were performed between sexes.
Results: Significant gender differences were observed in mandibular angle, mandible length, antegonial notch distance, intercondylar width, and intergonial width (all p < 0.001). Ramus length and chin width did not demonstrate statistically significant differences. Non-metric analysis revealed significant gender differences in chin morphology and inferior mandibular border contour (p < 0.001). Males predominantly exhibited a round or square chin (79.5%) and a rocker-shaped inferior border, whereas females commonly demonstrated a pointed chin (82.3%) and a straight inferior mandibular border (94.4%).
Conclusions: The gender-specific mandible features are characterized by differences in angularity, transverse width, antegonial morphology, and inferior border contour. These findings provide population-specific morphological reference ranges that may support individualized preoperative assessment for mandibular contouring in facial feminization surgery.
Methods: A retrospective analysis was conducted on 275 Korean patients who underwent facial CT between 2017 and 2019. Three- dimensional cephalometric analysis was performed to evaluate angular, linear, and transverse mandibular parameters, as well as non-metric features including chin shape and inferior mandibular border contour. Statistical comparisons were performed between sexes.
Results: Significant gender differences were observed in mandibular angle, mandible length, antegonial notch distance, intercondylar width, and intergonial width (all p < 0.001). Ramus length and chin width did not demonstrate statistically significant differences. Non-metric analysis revealed significant gender differences in chin morphology and inferior mandibular border contour (p < 0.001). Males predominantly exhibited a round or square chin (79.5%) and a rocker-shaped inferior border, whereas females commonly demonstrated a pointed chin (82.3%) and a straight inferior mandibular border (94.4%).
Conclusions: The gender-specific mandible features are characterized by differences in angularity, transverse width, antegonial morphology, and inferior border contour. These findings provide population-specific morphological reference ranges that may support individualized preoperative assessment for mandibular contouring in facial feminization surgery.
E-Poster
RO-0066
RO-0066
- Title
- Donor-Site-Sparing Biomaterial-Based and Tissue-Engineered Grafts versus Iliac Crest Grafting for Secondary Alveolar Cleft Reconstruction: A Systematic Review and Meta-Analysis of Volumetric Stability and Clinical Outcomes
- Author(s)
- Albertus Andika Wongjaya
- Affiliation
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Lambung Mangkurat, Ulin General Hospital, Banjarmasin, Indonesia
Donor-Site-Sparing Biomaterial-Based and Tissue-Engineered Grafts versus Iliac Crest Grafting for Secondary Alveolar Cleft Reconstruction: A Systematic Review and Meta-Analysis of Volumetric Stability and Clinical Outcomes RO-0066
Albertus Andika Wongjaya · Research
Introduction: Despite decades as the reference standard for secondary alveolar cleft reconstruction, iliac crest bone grafting (ICBG) necessitates a second surgical site with well-documented sequelae. Biomaterial-based and tissue-engineered alternatives have emerged, yet no meta-analysis has synthesized their reconstructive, perioperative, economic, and donor-site morbidity outcomes against ICBG.
Methods: Following PRISMA 2020 (PROSPERO: CRD420261457850), six databases (PubMed, Scopus, EBSCO, ScienceDirect, Cochrane, and Sage) were searched through May 2026. Twenty-one studies (N=774; 348 biomaterial, 426 ICBG) spanning five graft categories were analyzed using DerSimonian–Laird random-effects models; zero-event outcomes were pooled via Peto odds ratio. Risk of bias was assessed with RoB-2 and ROBINS-I; certainty with GRADE framework.
Results: Biomaterial-based and tissue-engineered grafts demonstrated comparable bone fill (k=11; MD +0.15%, 95% CI −2.30 to +2.59; P=0.91; I²=0%), volumetric stability (k=5; MD −34.09 mm³, 95% CI −135.95 to +67.77; P=0.51; I²=0%), and canine eruption (k=4; RR 1.00, 95% CI 0.88–1.14; I²=0%), with no difference among graft categories (P=0.83). Operative time was significantly shorter (k=7; MD −30.42 min, 95% CI −37.01 to −23.83; P<0.00001), as was hospital stay (k=5; MD −1.55 days, 95% CI −2.58 to −0.52; P<0.001). Total hospital cost favored biomaterials despite higher material costs (MD −$2,056; P<0.01). Donor-site pain was virtually absent (0/302 vs 59/289; Peto OR 0.04, 95% CI 0.02–0.08; P<0.00001), as was gait disturbance (0/38 vs 38/38; Peto OR 0.02, 95% CI 0.01–0.05; P<0.00001). Recipient-site complications were equivalent: dehiscence (k=7; RR 1.24, 95% CI 0.74–2.06; P=0.41) and infection (k=4; RR 0.42, 95% CI 0.13–1.36; P=0.15).
Conclusion: Biomaterial-based and tissue-engineered grafts achieve reconstructive parity with autologous ICBG while eliminating donor-site morbidity, shortening perioperative recovery, and reducing hospital expenditure, establishing them as a compelling evidence-based alternative for secondary alveolar cleft reconstruction.
Methods: Following PRISMA 2020 (PROSPERO: CRD420261457850), six databases (PubMed, Scopus, EBSCO, ScienceDirect, Cochrane, and Sage) were searched through May 2026. Twenty-one studies (N=774; 348 biomaterial, 426 ICBG) spanning five graft categories were analyzed using DerSimonian–Laird random-effects models; zero-event outcomes were pooled via Peto odds ratio. Risk of bias was assessed with RoB-2 and ROBINS-I; certainty with GRADE framework.
Results: Biomaterial-based and tissue-engineered grafts demonstrated comparable bone fill (k=11; MD +0.15%, 95% CI −2.30 to +2.59; P=0.91; I²=0%), volumetric stability (k=5; MD −34.09 mm³, 95% CI −135.95 to +67.77; P=0.51; I²=0%), and canine eruption (k=4; RR 1.00, 95% CI 0.88–1.14; I²=0%), with no difference among graft categories (P=0.83). Operative time was significantly shorter (k=7; MD −30.42 min, 95% CI −37.01 to −23.83; P<0.00001), as was hospital stay (k=5; MD −1.55 days, 95% CI −2.58 to −0.52; P<0.001). Total hospital cost favored biomaterials despite higher material costs (MD −$2,056; P<0.01). Donor-site pain was virtually absent (0/302 vs 59/289; Peto OR 0.04, 95% CI 0.02–0.08; P<0.00001), as was gait disturbance (0/38 vs 38/38; Peto OR 0.02, 95% CI 0.01–0.05; P<0.00001). Recipient-site complications were equivalent: dehiscence (k=7; RR 1.24, 95% CI 0.74–2.06; P=0.41) and infection (k=4; RR 0.42, 95% CI 0.13–1.36; P=0.15).
Conclusion: Biomaterial-based and tissue-engineered grafts achieve reconstructive parity with autologous ICBG while eliminating donor-site morbidity, shortening perioperative recovery, and reducing hospital expenditure, establishing them as a compelling evidence-based alternative for secondary alveolar cleft reconstruction.
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