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

<i>Objective</i>To determine the effect of early hard palate closure by means of a Vomer flap (VF) on the nutritional status of children with cleft lip and palate.<i>Design</i>Multicenter retrospective cohort study.<i>Setting</i>Three referral centers for oral clefts.<i>Patients, Participants</i>Nonsyndromic children with UCLP or BCLP.<i>Interventions:</i> Early hard palate closure with a VF at cheiloplasty around 3 months versus isolated cheiloplasty, both followed by palatoplasty around 9 to 10 months.<i>Main Outcome Measure(s)</i>Anthropometric measures (weight and height) and related weight-for-age and height-for-age Z-scores at the time of cheiloplasty and palatoplasty.<i>Results</i>Between 2012 and 2024, 122 children with UCLP or BCLP underwent cleft repair surgery. Median age at cheiloplasty was 111 (99-126) days and 304 (284-342) at palatoplasty. In 60% of them (n = 73), a VF was performed simultaneously with cheiloplasty. Weight increase between cheiloplasty and palatoplasty was slightly more for the VF group compared to the control group by 0.24 kg (SE = 0.15, <i>P</i> = .13). No height difference was measured between the groups (<i>P</i> = .80). Z-score variation between cheiloplasty and palatoplasty was significantly different for all study groups, indicating a strong normalization of the growth curve after cheiloplasty (<i>P</i> < .001).<i>Conclusions</i>Early hard palate closure using a VF may favor growth in children with cleft lip and palate. The deviation from the normative growth curve of infants decreases significantly between cheiloplasty and palatoplasty, regardless of whether a VF was performed.