Affiliation:
1. University of Minnesota Medical School‐Twin Cities Minneapolis Minnesota U.S.A.
2. Geisel School of Medicine Dartmouth College Hanover New Hampshire U.S.A.
3. Children's Minnesota Pediatric Otolaryngology & Facial Plastic Surgery Minneapolis Minnesota U.S.A.
4. Department of Otolaryngology‐Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A.
5. Department of Otolaryngology Bahir Dar University College of Health Sciences Bahir Dar Ethiopia
Abstract
ObjectivesTo assess the effect of palatoplasty on growth velocity in undernourished and nourished orally fed children with cleft palate.MethodsA retrospective chart review was conducted using a data query with cleft‐associated ICD‐10 and ICD‐9 codes to identify children who underwent cleft palate repair between 2006 and 2022 at a tertiary pediatric hospital. Data gathered included demographics, admission variables, weight gain, and weight percentile as per the WHO growth chart data. Inclusion was limited to patients with complete growth data and without parenteral feeding support. Nutritional status was defined as undernourished (≤3rd percentile) and nourished (>3rd percentile). Between and within‐group comparisons were made using nonparametric tests.ResultsA total of 192 patients met the study criteria. Among undernourished patients, the median pre‐ and postsurgical weekly weight gain was 0.09 kg and 0.05 kg (p = <0.0001), and the median growth percentiles were 0.67% and 1.1%, respectively (p = 0.03). Among nourished patients, the median pre‐ and postsurgical weekly weight gain was 0.12 kg and 0.07 kg (p = <0.0001), and the median growth percentiles were 25.4% and 29.5%, respectively (p = <0.0001). The postsurgical reduction in weight gain per week was similar across nutritional status (p = 0.43), however, the nourished group demonstrated a larger increase in median growth percentile (3.3% vs. 0.23%; p = 0.03).ConclusionThis study demonstrates that palatoplasty does not independently improve growth velocity in children who were able to maintain an oral preoperative diet. In the case of undernourished children, there was no clinically significant improvement in postoperative growth percentiles.Level of Evidence3 Laryngoscope, 2024