Impact of Vomer Flap on Nutritional Status in Infants With Cleft Lip and Palate: A Multicenter Retrospective Cohort Study.

Abstract

ObjectiveTo determine the effect of early hard palate closure by means of a Vomer flap (VF) on the nutritional status of children with cleft lip and palate.DesignMulticenter retrospective cohort study.SettingThree referral centers for oral clefts.Patients, ParticipantsNonsyndromic children with UCLP or BCLP.Interventions: Early hard palate closure with a VF at cheiloplasty around 3 months versus isolated cheiloplasty, both followed by palatoplasty around 9 to 10 months.Main Outcome Measure(s)Anthropometric measures (weight and height) and related weight-for-age and height-for-age Z-scores at the time of cheiloplasty and palatoplasty.ResultsBetween 2012 and 2024, 122 children with UCLP or BCLP underwent cleft repair surgery. Median age at cheiloplasty was 111 (99-126) days and 304 (284-342) at palatoplasty. In 60% of them (n = 73), a VF was performed simultaneously with cheiloplasty. Weight increase between cheiloplasty and palatoplasty was slightly more for the VF group compared to the control group by 0.24 kg (SE = 0.15, P = .13). No height difference was measured between the groups (P = .80). Z-score variation between cheiloplasty and palatoplasty was significantly different for all study groups, indicating a strong normalization of the growth curve after cheiloplasty (P < .001).ConclusionsEarly hard palate closure using a VF may favor growth in children with cleft lip and palate. The deviation from the normative growth curve of infants decreases significantly between cheiloplasty and palatoplasty, regardless of whether a VF was performed.