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Impact of Vomer Flap on Nutritional Status in Infants With Cleft Lip and Palate: A Multicenter Retrospective Cohort

Sofia Bachini1, Robin Delnoij2, Edith Visser3

  • 1Department of Plastic and Reconstructive Surgery, Frisius Medical Center Leeuwarden, Leeuwarden, The Netherlands.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|October 9, 2025
PubMed

Insights

Early hard palate closure using a Vomer flap (VF) in infants with cleft lip and palate may improve nutritional status. Growth curves normalized significantly post-surgery, regardless of VF use.

Area of Science:

  • Pediatric Surgery
  • Craniofacial Surgery
  • Nutritional Science

Background:

  • Cleft lip and palate significantly impact infant nutrition and growth.
  • Early surgical intervention is crucial for optimizing outcomes in children with clefts.
  • The Vomer flap (VF) technique offers potential benefits for early hard palate closure.

Purpose of the Study:

  • To evaluate the effect of early hard palate closure with a Vomer flap (VF) on the nutritional status of children with cleft lip and palate.
  • To compare growth parameters between infants undergoing early VF closure and those with isolated cheiloplasty.

Main Methods:

  • Multicenter retrospective cohort study involving 122 nonsyndromic children with unilateral or bilateral cleft lip and palate.
  • Comparison of anthropometric measures (weight, height) and Z-scores before and after cheiloplasty and palatoplasty.
  • Intervention group received early hard palate closure with VF at cheiloplasty (approx. 3 months); control group had isolated cheiloplasty.

Main Results:

  • Weight increase was slightly greater in the VF group (0.24 kg), though not statistically significant (P=.13).
  • No significant height differences were observed between groups (P=.80).
  • A significant normalization of weight-for-age and height-for-age Z-scores was observed between cheiloplasty and palatoplasty in all groups (P<.001).

Conclusions:

  • Early hard palate closure with a Vomer flap (VF) may positively influence growth in infants with cleft lip and palate.
  • Regardless of VF use, surgical intervention significantly improves growth trajectories, reducing deviation from normative growth curves.

Keywords:
anthropometrycleft lip and palatehard palatepalatoplastyretrospective studysurgical techniqueutrition

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