Association of Cleft Phenotype Severity With Childhood Secondary Nasal Intervention Burden and Airway Morbidity Following Primary Cheilorhinoplasty
Victoria Kong, Andrew Salib, Omar Allam, Karen Bach, Samira Glaeser-Khan, Samuel Knoedler, Leonard Knoedler, Martin Kauke-Navarro, Michael AlperovichBackground:
Simultaneous primary cheilorhinoplasty offers early aesthetic and functional benefits, yet the longitudinal childhood surgical burden across cleft phenotype remains poorly defined. This study compared the timing, frequency, and likelihood of childhood secondary nasal intervention following primary simultaneous cheilorhinoplasty.
Methods:
A multicenter retrospective study using the Pediatric Health Information System (2004–2025) identified patients 16 years of age or younger who underwent primary cheilorhinoplasty at less than 12 months of age. Patients were stratified by cleft phenotype [unilateral cleft lip (UCL), bilateral cleft lip (BCL), unilateral cleft lip and palate (UCLP), and bilateral cleft lip and palate (BCLP)]. Negative binomial regression, Cox proportional hazards modeling, and multivariable logistic regression evaluated the rate, timing, and probability of secondary nasal intervention before age 16.
Results:
Of 1291 patients (median follow-up: 8.3 y), secondary intervention rates were significantly higher for UCLP (aIRR: 2.86) and BCLP (aIRR: 3.73) relative to UCL (all
Conclusions:
Cleft phenotype severity is independently associated with secondary nasal surgical burden. Greater phenotypic severity is linked to earlier, more frequent, and more probable nasal surgery, with burden highest in BCLP, followed by UCLP, relative to UCL.