Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Optimal Timing of Cleft Lip Repair: Correlation With Scar Formation and Revision Rates.
СтатьяНазвание и аннотация: Перевод в очереди
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Hayden Jamil, Crafton Christopher L, Keating Julia, Rosen Ross, Wang Howard, Rabbani Cyrus, Gourishetti Saikrishna
Аннотация
OBJECTIVE: To evaluate whether earlier timing of cleft lip repair (CLR) is associated with differences in the incidence of hypertrophic scar (HTS) formation and the need for revision surgery.
STUDY DESIGN: Retrospective cohort study.
SETTING: TriNetX Analytics Network, a federated database of de-identified health records from multiple healthcare institutions.
METHODS: Infants who underwent primary CLR before 1 year of age were identified using ICD-10 and CPT codes. Patients were categorized into early cleft lip repair (ECLR, <3 months) and traditional cleft lip repair (TLR, 3-12 months) groups. Propensity score matching was performed. Rates of HTS and revision surgery were compared between groups using chi-squared tests and regression analyses.
RESULTS: Among 6786 patients, 4321 underwent ECLR and 2465 underwent TLR. HTS was significantly less common in the ECLR group (3.2%) than in the TLR group (5.2%, P = .002). Increasing age at repair was positively correlated with HTS incidence (r2 = 0.58, P = .048). However, revision surgery was more frequent following ECLR (6.6%) compared to TLR (2.6%, P < .001) with age inversely correlated to revision rate (r2 = 0.52, P = .104). These differences persisted after propensity score matching for demographic and clinical variables.
CONCLUSION: Earlier CLR (<3 months) is associated with a lower rate of hypertrophic scarring but a higher rate of revision surgery. These findings underscore a trade-off in timing decisions and may guide shared decision-making for surgical planning in patients with cleft lip.
STUDY DESIGN: Retrospective cohort study.
SETTING: TriNetX Analytics Network, a federated database of de-identified health records from multiple healthcare institutions.
METHODS: Infants who underwent primary CLR before 1 year of age were identified using ICD-10 and CPT codes. Patients were categorized into early cleft lip repair (ECLR, <3 months) and traditional cleft lip repair (TLR, 3-12 months) groups. Propensity score matching was performed. Rates of HTS and revision surgery were compared between groups using chi-squared tests and regression analyses.
RESULTS: Among 6786 patients, 4321 underwent ECLR and 2465 underwent TLR. HTS was significantly less common in the ECLR group (3.2%) than in the TLR group (5.2%, P = .002). Increasing age at repair was positively correlated with HTS incidence (r2 = 0.58, P = .048). However, revision surgery was more frequent following ECLR (6.6%) compared to TLR (2.6%, P < .001) with age inversely correlated to revision rate (r2 = 0.52, P = .104). These differences persisted after propensity score matching for demographic and clinical variables.
CONCLUSION: Earlier CLR (<3 months) is associated with a lower rate of hypertrophic scarring but a higher rate of revision surgery. These findings underscore a trade-off in timing decisions and may guide shared decision-making for surgical planning in patients with cleft lip.