{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:42:09Z","timestamp":1793068929021,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>To assess the prevalence of acute and chronic malnutrition at the time of surgery in patients with cleft lip and\/or palate (CLP) at our institution, and to quantify nutrition as a risk factor for postsurgical complications following CLP surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of 855 children undergoing initial cleft lip or palate surgery, or revision surgery after fistula\/dehiscence of initial cleft repair. We measured acute and chronic malnutrition using World Health Organization Z\u2010scores of weight\u2010for\u2010age and height\u2010for\u2010age, respectively, and noted any postsurgical fistula or dehiscence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among patients with cleft lip, 22.3% were at least moderately chronically malnourished at the time of initial repair, and 17.5% were at least moderately acutely malnourished. Among patients undergoing initial repair of cleft palate, 20.9% were at least moderately chronically malnourished, and 8.1% were at least moderately acutely malnourished. Increasing nutritional status, as measured by height\u2010for\u2010age, predicts decreased odds of fistula (OR 0.78,\n                      <jats:italic>P<\/jats:italic>\n                      = .01) after cleft palate surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic malnutrition significantly increases the risk of fistula formation in patient with cleft palate. Preoperative strategies to manage this risk and influence surgical timing can avoid morbid and costly postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 131:E2060\u2013E2065, 2021\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29209","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T08:46:06Z","timestamp":1605170766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Malnutrition as a Risk Factor in Cleft Lip and Palate Surgery"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8227-2779","authenticated-orcid":false,"given":"Paul J.","family":"Escher","sequence":"first","affiliation":[{"name":"University of Minnesota Medical School Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Zavala","sequence":"additional","affiliation":[{"name":"Department of ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lee","sequence":"additional","affiliation":[{"name":"Children's Minnesota Research Institute Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianne Barnett","family":"Roby","sequence":"additional","affiliation":[{"name":"Department of ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9733-4688","authenticated-orcid":false,"given":"Sivakumar","family":"Chinnadurai","sequence":"additional","affiliation":[{"name":"Department of ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20735"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182402dd1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2007.11.001"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1995.02170230072010"},{"key":"e_1_2_6_7_1","volume-title":"Joint Child Malnutrition Estimates 2017","author":"United Nations Children's Fund, World Health Organization & World Bank Group","year":"2017"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2013.14.96.1914"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12231"},{"key":"e_1_2_6_10_1","unstructured":"World Health Organization.WHO Child Growth Standards. 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