Risk Factors for Delayed Diagnosis of Positional Plagiocephaly: A Retrospective Review of 25,322 Patients

BACKGROUND: Orofacial clefts are a prevalent birth defect that affects approximately 7.75 neonates out of every 10,000 live births. The optimal timing for repair of the cleft lip has yet to be objectively validated and previous supporting evidence guiding ideal timing may be outdated. Earlier repair takes advantage of the high degree of plasticity within the nasal cartilage and maxilla as a result of high concentrations of circulating maternal estrogen in the infant. Accomplishing the operative repair of the cleft lip in infancy has the capacity to decrease restrictive scar formation, improve aesthetic outcomes, accelerate weight gain, and improve feeding and maternal-infant socialization. In this study, we present unilateral cleft patients prospectively enrolled in an early cleft lip repair (ECLR) multidisciplinary protocol created to facilitate the safe and effective repair of the cleft lip and nostril.