Does the type of cleft palate contribute to the need for secondary surgery? A national perspective

Authors

  • James A. Owusu MD,

    Corresponding author
    • Department of Otolaryngology–Head and Neck Surgery , University of Minnesota, Minneapolis, Minnesota, U.S.A
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  • Meixia Liu MS,

    1. Children's Hospitals and Clinics of Minnesota , Minneapolis, Minnesota, U.S.A
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  • James D. Sidman MD,

    1. Department of Otolaryngology–Head and Neck Surgery , University of Minnesota, Minneapolis, Minnesota, U.S.A
    2. Children's Hospitals and Clinics of Minnesota , Minneapolis, Minnesota, U.S.A
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  • Andrew R. Scott MD

    1. Department of Otolaryngology–Head and Neck Surgery , Floating Hospital for Children–Tufts Medical Center, Boston, Massachusetts, U.S.A
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  • Presented at the Society for Ears Nose and Throat Advancement in Children Annual Meeting, Charleston, SC, November 30–December 2, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Send correspondence to James A. Owusu, MD, Department of Otolaryngology, University of Minnesota Medical School, Mayo Mail Code 396, 420 Delaware Street SE, Minneapolis, MN 55455. E-mail: owusuja@gmail.com

Abstract

Objectives/Hypothesis

To determine whether the type of cleft palate is associated with a need for secondary surgery (oronasal fistula repair, speech surgery) after primary cleft palate repair.

Study Design

Retrospective analysis of a national pediatric database (2009 Kids' Inpatient Database).

Methods

We identified two distinct cohorts of children who underwent primary and secondary (revision) cleft palate repairs, respectively, from a national, pediatric database (2009 Kids' Inpatient Database). Revision ratios for each cleft palate diagnosis were calculated to identify diagnoses with higher rates of revision. Revision ratio was calculated by dividing the relative frequency of each diagnosis in the secondary repair cohort by the corresponding relative frequency in the primary repair cohort.

Results

In 2009, there were 1942 cases of primary cleft palate repair in the 44 states participating in the KID's inpatient database. Fifty-two percent (n=1018) were male. The average age at the time of surgery was 13.36 months. In the same year secondary cleft palate procedures were performed on 724 different patients, 54% (n=388) were males. The average age for secondary procedures was 59 months. Cleft lip and palate diagnoses had higher revision rate ratios (1.92) compared to cleft palate only (0.54) P <0.05.

Conclusion

Children with an initial diagnosis of cleft lip and palate, which is more severe than cleft palate only, have comparatively higher rates of secondary cleft palate procedures than children with cleft palate only.

Level of Evidence

N/A. Laryngoscope, 123:2387–2391, 2013

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