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Updated: Apr 25, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Early complications after cleft palate repair: a multivariate statistical analysis of 709 patients
Gaurav Shekhar Deshpande1, Alex Campbell, Rasika Jagtap
1From the *Operation Smile, Guwahati Comprehensive Cleft Care Center Guwahati, Assam, India; †Operation Smile Inc, Norfolk, Virginia; ‡Wake Forest University, Winston-Salem, North Carolina; and §University of Rochester, Rochester, New York.
Insights
This study on primary cleft palate repairs found a 3.9% fistula rate in nonsyndromic children. Complication rates were comparable to developed countries, validating the surgical model in developing regions.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Cleft palate repair is a common pediatric surgical procedure.
- Understanding early complication rates is crucial for optimizing surgical outcomes and patient care.
- Establishing benchmarks for surgical outcomes in developing regions is essential.
Purpose of the Study:
- To determine the incidence of early complications following primary cleft palate repair in nonsyndromic children.
- To analyze the impact of cleft extent, repair type, age at repair, and surgeon on complication rates.
- To evaluate the efficacy of a comprehensive cleft care model in a developing country setting.
Main Methods:
- Retrospective analysis of 709 consecutive primary cleft palate repairs.
- Data collected from Guwahati Comprehensive Cleft Care Center between April 2011 and December 2012.
- Analysis of early complications including wound dehiscence, fistula formation, hanging palate, and flap necrosis.
Main Results:
- Overall early complication rate was assessed, with a 2.4% rate requiring return to the operating room for bleeding control.
- Postoperative fistula incidence was 3.9% (20/512).
- A statistically significant increase in fistula incidence was observed for Veau IV clefts; no significant differences were found based on surgeon, sex, age, or repair type.
Conclusions:
- The complication and fistula rates are comparable to published data from developed countries.
- The study supports the effectiveness of the surgical delivery model for cleft care in developing regions.
- Further research can focus on specific interventions to reduce fistula rates in severe cleft types.
Abstract:
This study presents a large consecutive institutional experience with primary cleft palate repairs. The purpose of this study was to determine the incidence of early complications after cleft palate surgery in a series of nonsyndromic children treated at the authors' comprehensive cleft center. This retrospective analysis includes 709 consecutive patients with cleft palate treated by 6 different staff surgeons at Guwahati Comprehensive Cleft Care Center between April 2011 and December 2012. Secondary cases were excluded from this study. The patients were initially followed up between 1 week and 1 month after surgery. The overall incidence of early complications was determined, and the effect of the extent of clefting, the type of repair, the age at repair, and the operating surgeon were analyzed. Early complications in this study include dehiscence of the wound, fistula formation, hanging palate, and total or partial flap necrosis. There was a 2.4% rate (17/709) of take-back to the operating room in the immediate postoperative period for control of bleeding, although no blood transfusions were required. The incidence of postoperative fistulas in this series was 3.9% (20/512). There was a statistically significant increase in the incidence of cleft palatal fistula for Veau IV clefts, but there were no significant differences with respect to operating surgeon, patient sex, patient age, and type of palatoplasty. The complication and fistula rate is consistent with other published reports from developed countries and provides evidence for the value of this model for surgical delivery in the developing world.
