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Comparative Study
. 2025 May 1;36(3):1079-1082.
doi: 10.1097/SCS.0000000000010065. Epub 2024 Feb 27.

Factors Associated with Delayed Palatoplasty Before, During, and After the COVID-19 Pandemic

Ibrahim Khansa  1 , Sarah Hatch Pollard  2 , Alyssa Fogolin  1 , Adriane Baylis  1 , Thomas J Sitzman  3 , Kathy L Chapman  2 , Richard E Kirschner  1
Affiliations
Comparative Study

Factors Associated with Delayed Palatoplasty Before, During, and After the COVID-19 Pandemic

Ibrahim Khansa et al. J Craniofac Surg. .

Abstract

Background: Cleft palatoplasty is typically performed around 10 to 12 months of age in the US, and delays can negatively affect speech development. Early during COVID-19, elective surgeries were canceled. The aims of this study were to (1) identify overall risk factors for greater age at palatoplasty and (2) analyze delays in palatoplasty during COVID-19.

Methods: This study was part of a larger prospective, multicenter comparative study of speech outcomes in palatoplasty. Participants underwent palatoplasty between March 2019 and September 2022 at 18 pediatric hospitals in the United States. Ages were corrected for prematurity. Dates of palatoplasty were divided into 4 periods corresponding to different phases of the pandemic. Factors analyzed included region, language, adoption status, sex, ethnicity, race, rurality, health insurance type, and cleft type. Analyses were performed using ANOVA, Student's t est, and multivariable linear regression, with a P value of ≤0.05 being significant.

Results: Nine hundred twenty-eight participants were included. Average corrected age at palatoplasty was 374 days. In univariable analysis, palatoplasty was performed later in children who were Hispanic ( P =0.003), of a race other than White, Black, or Asian ( P <0.001), and without private insurance ( P <0.001). On multivariable regression, predictors of delayed palatoplasty were Hispanic ethnicity ( P =0.015), from other race ( P <0.001), and without private insurance ( P <0.001). During COVID-19, disproportionate delays occurred in patients who were female, of other races, from nonrural areas, and on Medicaid.

Conclusions: Palatoplasty was performed later in vulnerable populations. Some of these populations were also disproportionately affected by COVID-19 delays. Providers should be aware of these differences as they pertain to equitable access to craniofacial care.

Level of evidence: III.

Keywords: COVID-19; cleft palate repair; delay.

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Conflict of interest statement

The authors report no conflicts of interest.

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References

    1. Dorf D, and Curtin JW Early cleft palate repair and speech outcome. Plast Reconstr Surg 1982;70:75 - PubMed
    1. Slator R, Perisanidou LI, Sell D, Sandy J, Ness AR, Wills AK. Surgical sequence, timing and volume, and variation in dento-facial outcome, speech and secondary surgery in children with unilateral cleft lip and palate: The Cleft Care UK Study. Orthod Craniofac Res 2022. Epub ahead of print. - PubMed
    1. Yang Y, Li Y, Zheng Q et al. Velopharyngeal function of patients with cleft palate after primary palatoplasty: relevance of sex, age, and cleft type. J Craniofac Surg 2013;24(3):923–8 - PubMed
    1. Chapman KL, Hardin-Jones MA, Schulte J et al. Timing of palatal surgery and speech outcome. The Cleft palate-craniofacial journal. 2008. May;45(3):297–308. - PubMed
    1. Willadsen E, Lohmander A, Emborg B et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds-consonant proficiency and errors. J Plast Surg Hand Surg. 2017;51(1):38–51. - PubMed