52. THE EFFECT OF PREOPERATIVE PATIENT CHARACTERISTICS ON POSTOPERATIVE OUTCOMES OF CLEFT PALATE REPAIR: AN ANALYSIS OF GLOBAL SMILE TRAIN DATA

Abstract

PURPOSE: The aim of this study was to identify patient characteristics that contribute to fistula and postoperative speech outcomes using global Smile Train data. METHODS: Analysis of palatoplasty outcomes was performed for 1,110 Smile Train partner hospitals. Patient factors following palatoplasty, including age, weight, and region, were correlated with fistula occurrence and speech outcomes. RESULTS: 2,560 patients were analyzed. The patients were 46.6% female and 27.5% underweight by WHO standards. Average age at palatoplasty was 24.7 + 0.5 months and at speech assessment was 6.8 ± 0.1 years. Underweight patients had higher incidence of hypernasality and decreased speech intelligibility. Palatoplasty when under 6 months or over 18 months of age had higher rates of affected nasality, intelligibility, and fistula formation. The same findings were seen in Central/South American and African patients, in addition to increased VPD and fistula surgery compared to Asian patients. Central/South American patients were also more likely to require VPD assessment. CONCLUSION: In the largest global cleft outcomes study to date, age and nutrition status were significant predictors of speech outcomes and fistula occurrence following palatoplasty. Outcomes were also significantly impacted by location, demonstrating the need to cultivate longitudinal initiatives to reduce regional disparities. These results underscore the importance of Smile Train’s continual expansion of accessible surgical intervention, nutritional support, and speech-language care.