Cleft Palate Revision Surgery: A Report on Sociodemographic and Racial Influences.

OBJECTIVE

To evaluate the impact of sociodemographic factors on the likelihood of subsequent cleft surgeries after primary palatoplasty using a large national data set.

DESIGN

A retrospective cohort study was designed using Epic Cosmos, a HIPAA-compliant database of >200 million patients from >1000 hospitals.

PATIENTS: Patients with cleft palate who underwent primary palatoplasty from 2013 to 2023 were queried and divided into sociodemographic cohorts based on: (1) Social Vulnerability Index (SVI), 2) race, (3) urbanicity.

MAIN OUTCOME MEASURES: The rate of major revision surgeries and surgical correction of velopharyngeal insufficiency (VPI).

RESULTS

Socially vulnerable and Black patients displayed the lowest rates of major revisions and speech surgeries. Vulnerable patients of minority and language status were also susceptible to low revision rates (P<.001). Asian and Pacific Islander race exhibited the highest rate of major revisions and speech surgery.

CONCLUSIONS

Socially vulnerable minorities and Black patients undergo fewer corrective procedures than their counterparts. This may indicate differences in access and under-recognition of surgical needs in such patients.