# Optimal Outcome Reporting 5 and 8 Years Following Cleft Palate Repair — GCMD Library

<i>Balkin, Daniel M. MD, PhD; Incorvia, Joseph MScGH; Reed, Brianna BS; Nuzzi, Laura C. BA; Hughes, Christopher D. MD, MPH; Catallozzi, Liza MS, CCC-SLP; Clark, Roseanne MS, CCC-SLP; Kummer, Ann W. PhD, CCC-SLP, FASHA; Meara, John G. MD, DMD, MBA</i><div><i><br></i></div><div><b>Background: 
</b></div><div>No widely applied standardized outcome metric exists following palatoplasty. We created a novel quality metric, optimal outcome reporting (OOR), reflecting patients who experienced the best outcome: normal velopharyngeal function and no unintended fistula after a single operation. We assessed OOR at 5 and 8 years of age in a patient cohort.
</div><div><br></div><div><b>Methods: 
</b></div><div>Data collected included sex, ethnicity, Veau classification, syndromic status, operative age, presence of fistulae, and speech assessments at 5 and 8 years. Patients with submucous clefts were excluded.
</div><div><br></div><div><b>Results: 
</b></div><div>The cohort comprised 94 patients. Median operative age was 10 months; 45% were male, 46% were non-White, and 25% had syndromic diagnoses. The most common cleft types were Veau I (32%) and Veau III (28%). At 5 years, 69% (65 of 94) achieved OOR, with suboptimal outcomes due to multiple operations (9), velopharyngeal insufficiency (19), or fistula (1). At 8 years, 73% (61 of 83) met OOR criteria; failures resulted from multiple operations (12), velopharyngeal insufficiency (9), or fistula (1). Patients with OOR were significantly younger at the time of palate repair. A higher proportion of patients with nonsyndromic diagnoses and those with Veau I/III clefts attained OOR compared with patients with syndromic diagnoses and other cleft types. Nine patients with speech-related suboptimal outcomes at 5 years demonstrated optimal outcomes by 8 years with speech therapy alone.
</div><div><br></div><div><b>Conclusions: 
</b></div><div>Cleft palate OOR describes the ideal outcome following primary palatoplasty. This simple surgical outcome metric can be applied to individual surgeons and across centers, facilitating benchmarking and quality improvement initiatives.</div><div><i>
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Type: video · 0 min · posted 2025-12-11
Canonical: https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308

## Chapters
- [0:00](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=0) Introduction to Optimal Outcome Reporting for Cleft Palate Repair

## Statements
- "There has not been a standardized way to measure outcomes after cleft palate repair" — Lizzie Lee (clinical) [0:09](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=9)
- "Optimal outcome reporting (OOR) is a new metric for measuring cleft palate repair outcomes" — Lizzie Lee (clinical) [0:14](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=14)
- "Best case surgical outcome for cleft palate repair is defined as one operation, no unintended fistula, and normal speech function" — Lizzie Lee (clinical) [0:20](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=20)
- "About 70% of patients achieve optimal outcome 5 years after cleft palate repair" — Lizzie Lee (epidemiological) [0:28](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=28)
- "Nearly 75% of patients achieve optimal outcome 8 years after cleft palate repair" — Lizzie Lee (epidemiological) [0:28](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=28)
- "Younger age at surgery is associated with better long-term outcomes after cleft palate repair" — Lizzie Lee (clinical) [0:39](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=39)
- "Specific cleft types are associated with better long-term outcomes after cleft palate repair" — Lizzie Lee (clinical) [0:39](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=39)
- "Absence of underlying syndromes is associated with better long-term outcomes after cleft palate repair" — Lizzie Lee (clinical) [0:39](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=39)
- "Optimal outcome reporting provides surgeons a clear, measurable way to track success" — Lizzie Lee (opinion) [0:47](https://library.globalcastmd.com/watch/optimal-outcome-reporting-5-and-8-years-following-cleft-palate-repair-11308?t=47)

## Transcript
How do we actually define a successful outcome after cleft palate surgical repair? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. For years we haven't had a standardized way to measure outcomes after cleft palate repair. So this study introduced a new metric called optimal outcome reporting or OOR. Basically, the best case surgical outcome means one operation, no unintended fistula, and normal speech function. They found that 5 years after repair, about 70% of the patients hit that ideal outcome, and by 8 years, that rate climbed to nearly 75%. Here's the interesting part. Kids who had surgery at a younger age with specific cleft types without underlying syndromes were more likely to do best in the long term. The takeaway, optimal outcome reporting gives surgeons a clear, measurable way to track success and a powerful tool to keep improving care. Let us know what you think in the comments below and stay tuned for more articles that you should know about.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai