{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:42:10Z","timestamp":1793068930307,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal age for cleft palate repair continues to be debated, with little discussion of surgical risk related to operative timing. This study of 3088 cleft palate patients analyzed the impact of surgical timing on perioperative and 30-day postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Primary cleft palate repairs were identified in the National Surgical Quality Improvement Program database from 2012 to 2015. Data were combed for total postoperative complications, rates of readmission and reoperation, operating room time, and length of stay. Bivariate analyses were performed comparing 3-month periods from months 6 to 18, and months 0 to 5, 18 to 23, 24 to 29, and 30 to 59.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Despite a higher proportion of isolated soft palate closure, children operated on before 6 months had a higher complication rate than children at other ages (7.1 percent versus 3.2 percent; OR, 2.4;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04), and higher rates of both readmission (3.6 percent versus 1.4 percent; OR, 3.6;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02) and reoperation (2.4 percent versus 0.5 percent; OR, 4.7;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04). There were no differences in short-term outcomes for any other age group younger than 5 years, and no differences in hospital length of stay among any age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The authors\u2019 findings suggest a relative contraindication to operation before 6 months. As there were no differences between any other age groups, long-term speech optimization should continue to be the primary consideration for operative planning. These findings improve the current rationale for palatoplasty timing, and can aid surgeons and parents in the surgical decision-making process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Therapeutic, III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/prs.0000000000007458","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T19:19:19Z","timestamp":1601666359000},"page":"131-137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["The Effect of Surgical Timing on 30-Day Outcomes in Cleft Palate Repair"],"prefix":"10.1097","volume":"147","author":[{"given":"Connor J.","family":"Peck","sequence":"first","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind U.","family":"Gowda","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake N.","family":"Shultz","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin T.","family":"Wu","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Bourdillon","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Singh","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek M.","family":"Steinbacher","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Section of Plastic Surgery, Yale School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"key":"R1-20250501","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/00006534-200008000-00026","article-title":"Optimal timing of cleft palate closure.","volume":"106","author":"Rohrich","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R2-20250501","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1097\/01.PRS.0000091245.32905.D5","article-title":"Velopharyngeal incompetence: A guide for clinical evaluation.","volume":"112","author":"Johns","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"R3-20250501","first-page":"945","article-title":"Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients.","volume":"16","author":"Chen","year":"2011","journal-title":"J Res Med Sci"},{"key":"R4-20250501","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1097\/SCS.0b013e3182587b34","article-title":"Velopharyngeal function of patients with cleft palate after primary palatoplasty: Relevance of sex, age, and cleft type.","volume":"24","author":"Yang","year":"2013","journal-title":"J Craniofac Surg"},{"key":"R5-20250501","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1597\/06-244","article-title":"Timing of palatal surgery and speech outcome.","volume":"45","author":"Chapman","year":"2008","journal-title":"Cleft Palate Craniofac J"},{"key":"R6-20250501","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00006534-198207000-00015","article-title":"Early cleft palate repair and speech outcome.","volume":"70","author":"Dorf","year":"1982","journal-title":"Plast Reconstr Surg"},{"key":"R7-20250501","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1597\/05-028.1","article-title":"Phonetic description of babbling in Danish toddlers born with and without unilateral cleft lip and palate.","volume":"43","author":"Willadsen","year":"2006","journal-title":"Cleft Palate Craniofac J"},{"key":"R8-20250501","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2319\/071312-580.1","article-title":"Maxillary growth and maturation during infancy and early childhood.","volume":"83","author":"Laowansiri","year":"2013","journal-title":"Angle Orthod"},{"key":"R9-20250501","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1597\/1545-1569_2001_038_0323_lteffm_2.0.co_2","article-title":"Long-term evidence for favorable midfacial growth after delayed hard palate repair in UCLP patients.","volume":"38","author":"Friede","year":"2001","journal-title":"Cleft Palate Craniofac J"},{"key":"R10-20250501","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1097\/SCS.0000000000001113","article-title":"Early complications after cleft palate repair: A multivariate statistical analysis of 709 patients.","volume":"25","author":"Deshpande","year":"2014","journal-title":"J Craniofac Surg"},{"key":"R11-20250501","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1597\/14-206","article-title":"Surgical complications in 1408 primary cleft palate repairs operated at a single center in Guwahati, Assam, India.","volume":"53","author":"Sch\u00f6nmeyr","year":"2016","journal-title":"Cleft Palate Craniofac J"},{"key":"R12-20250501","doi-asserted-by":"crossref","first-page":"e313","DOI":"10.1097\/GOX.0000000000000282","article-title":"A model humanitarian cleft mission: 312 cleft surgeries in 7 days.","volume":"3","author":"Fayyaz","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R13-20250501","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1177\/014107688808101208","article-title":"Sri Lankan cleft lip and palate project: A preliminary report.","volume":"81","author":"Lambadusuriya","year":"1988","journal-title":"J R Soc Med"},{"key":"R14-20250501","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1503\/cjs.003518","article-title":"Evaluation of the effectiveness of an enhanced recovery after surgery program using data from the National Surgical Quality Improvement Program.","volume":"62","author":"Gresham","year":"2019","journal-title":"Can J Surg"},{"key":"R15-20250501","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.surg.2005.08.016","article-title":"The NSQIP: A new frontier in surgery.","volume":"138","author":"Khuri","year":"2005","journal-title":"Surgery"},{"key":"R16-20250501","doi-asserted-by":"crossref","first-page":"39","DOI":"10.7812\/TPP\/11-127","article-title":"The power of the National Surgical Quality Improvement Program: Achieving a zero pneumonia rate in general surgery patients.","volume":"16","author":"Fuchshuber","year":"2012","journal-title":"Perm J"},{"key":"R17-20250501","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/j.jpeds.2015.02.007","article-title":"The impact of insurance, race, and ethnicity on age at surgical intervention among children with nonsyndromic craniosynostosis.","volume":"166","author":"Lin","year":"2015","journal-title":"J Pediatr"},{"key":"R18-20250501","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2015.9.FOCUS15383","article-title":"Complications after craniosynostosis surgery: Comparison of the 2012 Kids\u2019 Inpatient Database and Pediatric NSQIP Database.","volume":"39","author":"Lin","year":"2015","journal-title":"Neurosurg Focus"},{"key":"R19-20250501","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3171\/2015.4.PEDS14342","article-title":"Differences in surgical outcomes for patients with craniosynostosis in the US: Impact of socioeconomic variables and race.","volume":"17","author":"Shweikeh","year":"2016","journal-title":"J Neurosurg Pediatr"},{"key":"R20-20250501","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/00006534-199809010-00009","article-title":"Speech outcome and maxillary growth in patients with unilateral complete cleft lip\/palate operated on at 6 versus 12 months of age.","volume":"102","author":"Ysunza","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"R21-20250501","doi-asserted-by":"crossref","first-page":"202","DOI":"10.5999\/aps.2017.44.3.202","article-title":"Long-term follow-up study of young adults treated for unilateral complete cleft lip, alveolus, and palate by a treatment protocol including two-stage palatoplasty: Speech outcomes.","volume":"44","author":"Kappen","year":"2017","journal-title":"Arch Plast Surg"},{"key":"R22-20250501","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1097\/00006534-200005000-00032","article-title":"Cleft palate repair at 3 to 7 months of age.","volume":"105","author":"Kirschner","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R23-20250501","doi-asserted-by":"crossref","first-page":"e000063","DOI":"10.1136\/bmjpo-2017-000063","article-title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: A retrospective cohort study.","volume":"1","author":"Sitzman","year":"2017","journal-title":"BMJ Paediatr Open"},{"key":"R24-20250501","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/MAO.0b013e3181661866","article-title":"Ear surgery in infants under one year of age: Its risks and implications for cochlear implant surgery.","volume":"29","author":"J\u00f6hr","year":"2008","journal-title":"Otol Neurotol"},{"issue":"Suppl","key":"R25-20250501","doi-asserted-by":"crossref","first-page":"S116","DOI":"10.4103\/0970-0358.57202","article-title":"Management of cleft lip and palate in adults.","volume":"42","author":"Murthy","year":"2009","journal-title":"Indian J Plast Surg"},{"key":"R26-20250501","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1007\/s00268-012-1607-z","article-title":"Success and failure for children born with facial clefts in Africa: A 15-year follow-up.","volume":"36","author":"de Buys Roessingh","year":"2012","journal-title":"World J Surg"},{"key":"R27-20250501","doi-asserted-by":"crossref","first-page":"319e","DOI":"10.1097\/PRS.0b013e31823aea7e","article-title":"Comparison of fistula rates after palatoplasty for international and local surgeons on surgical missions in Ecuador with rates at a craniofacial center in the United States.","volume":"129","author":"Maine","year":"2012","journal-title":"Plast Reconstr Surg"},{"key":"R29-20250501","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.2106\/JBJS.18.01079","article-title":"The feasibility of a randomized controlled trial for open tibial fractures at a regional hospital in Uganda.","volume":"101","author":"Kisitu","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"R30-20250501","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1097\/SCS.0000000000001682","article-title":"The repair of international clefts in the current surgical landscape.","volume":"26","author":"Persing","year":"2015","journal-title":"J Craniofac Surg"},{"key":"R31-20250501","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1597\/14-193","article-title":"An assessment of 30-day complications in primary cleft palate repair: A review of the 2012 ACS NSQIP Pediatric.","volume":"53","author":"Paine","year":"2016","journal-title":"Cleft Palate Craniofac J"},{"key":"R32-20250501","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jamcollsurg.2016.08.542","article-title":"Development and evaluation of the American College of Surgeons NSQIP Pediatric surgical risk calculator.","volume":"223","author":"Kraemer","year":"2016","journal-title":"J Am Coll Surg"},{"key":"R33-20250501","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1097\/SCS.0000000000003646","article-title":"Does cleft palate width correlate with Veau classification and outcome?","volume":"28","author":"Wu","year":"2017","journal-title":"J Craniofac Surg"},{"key":"R34-20250501","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/00006534-199705010-00010","article-title":"Fistula formation and repair after palatal closure: An institutional perspective.","volume":"99","author":"Emory","year":"1997","journal-title":"Plast Reconstr Surg"},{"key":"R35-20250501","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1097\/PRS.0000000000005650","article-title":"Racial disparities in cleft palate repair.","volume":"143","author":"Wu","year":"2019","journal-title":"Plast Reconstr Surg"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T20:21:09Z","timestamp":1746130869000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,2]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000007458","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10,2]]}}}