Nasal Regurgitation and Weight Trends Before and After Palatal Lengthening in Patients with Cleft Palate Related Velopharyngeal Insufficiency

Files

Authors

• Lasya Marla, Michigan State University College of Human Medicine Medical Student
• Hamed Moshref, Michigan State University College of Human Medicine Medical Student
• Samuel Girian, Corewell Health West Resident
• Elizabeth Bushong, Corewell Health West Resident
• Anna Carlson, Corewell Health West
• John Girotto, Corewell Health West

Description

Individuals with cleft palate (CP) are more likely to face feeding and growth difficulties, which are often exacerbated by the presence of velopharyngeal insufficiency (VPI)/nasal regurgitation. Existing literature have explored short-term weight trends within the first 1-1.5 years of life; however, long-term BMI trends in older patients remain underinvestigated. Palatal lengthening (PL) aims to improve VPI, including nasal regurgitation, but its effects on nutritional status are not well known. This study evaluates the impact of PL on nasal regurgitation and weight trends in patients with cleft palate related VPI.

A retrospective review was conducted on patients who underwent PL to correct VPI at a single institution between 2010 and 2024. The presence or absence of nasal regurgitation and BMI percentiles were collected both pre- and post- operatively. Particularly, BMI percentiles were analyzed at the 6-month, 1 year, 3 years, and 5 years post-operative time points. Wilcoxon Signed Rank test was used to analyze differences in BMI pre- vs post- PL. T-test and Wilcoxon Rank Sum test were used to compare BMI between nasal regurgitation groups.

Our study included 47 patients with a mean age of 8.87 ± 3.76 years old at the time of PL. Prior to PL, 36.2% of patients experienced nasal regurgitation, which reduced to 19.2% post-operation (p = 0.022). The average pre-operative BMI percentile was 50% [25%, 85%]. At 6 months, 1 year, 3 years, and 5 years follow-up the average BMI percentiles were in the healthy weight category: 48.3%, 33.5%, 35.0%, and 34.5%. Of significance, the proportion of underweight patients decreased 6 months post-operation (p = 0.046), but changes were not noteworthy beyond this point of follow-up.

PL significantly reduces nasal regurgitation amongst patients with cleft palate related VPI. The post-operative BMI improvements suggests that PL may facilitate weight normalization via a reduction in nasal regurgitation. Such changes underscore the role of PL in improving nutritional outcomes. Overall, a multidisciplinary approach is essential to cleft repair.

Publication Date

5-8-2026

Disciplines

Plastic Surgery

Recommended Citation

Marla L, Moshref H, Girian S, Bushong E, Carlson A, Girotto J. Nasal regurgitation and weight trends before and after palatal lengthening in patients with cleft palate related velopharyngeal insufficiency. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2043