The Effect of Early Cleft Lip Repair on Infant Weight Gain

Abstract

with nonparamedian clefts or a comorbid craniofacial syndrome were excluded. Primary outcome variable was the total proportion of patients with CL/P who either underwent or were referred for orthognathic surgery (LF1) to correct midface hypoplasia. Secondary outcome variables were associations among cleft phenotype, midface hypoplasia severity, and number of cleft related surgeries with the eventual LF1 referral/recipiency. Descriptive and bivariate analysis was computed. RESULTS:An estimated 177 patients with CL/P met the inclusion criteria. In total, 90/177 (51%) patients underwent corrective LF1; however, 110/177 (62%) of patients were referred for surgery. Patients with secondary cleft palate involvement were referred for and underwent LF1 at significantly greater rates than those without secondary palate involvement (referred: 65% versus 13%, P = 0.001; underwent: 55% versus 0%, P < 0.001). Patients with BCLP were referred for and underwent LF1 at significantly higher rates that those with UCLP (referred: 71.0% versus 50.4%, P = 0.04; underwent: 84% versus 71%, P = 0.02). Number of secondary palate surgeries was positively correlated with increased LF1 referral (P = 0.02) but not LF1 recipiency (P = 0.15). CONCLUSIONS:The incidence of orthognathic surgery incidence in patients with repaired CL/P was 51% at our institution, marginally above the higher end of previously reported rates. However, this number is an underrepresentation of the true requirement for LF1 as 62% of patients were referred for surgical intervention of midface hypoplasia. This distinction should be considered when counseling families about the likelihood of future orthognathic surgery. Additionally, patients with clefts involving the secondary palate and patients with BCLP should be educated about the increased likelihood of requiring LF1 compared with patients without secondary palate involvement and patients with UCLP, respectively. REFERENCE: 1. Choi KJ, Wlodarczyk JR, Nagengast ES, et al. The likelihood of orthognathic surgery after orofacial cleft repair: a systematic review and meta-analysis [published online ahead of print, 2020 Nov 23].