Two-stage palatal repair in non-syndromic CLP patients using anterior to posterior closure is associated with minimal need for secondary palatal surgery.

"Declarations Ethics approval and consent to participateThis observational study was approved by the Ethics Committee of the University Medical Center Goettingen (21/4/20) in accordance with the Declaration of Helsinki. Informed Consent was Not Applicable. Consent for publicationNot applicable. Competing interestsThe authors declare no competing interests. Competing interests The authors declare no competing interests."

"Funding Open Access funding enabled and organized by Projekt DEAL."

"The study protocol had been approved by the local ethical committee (Registration Number 21/4/20). A cross-sectional analysis of patients listed in the data bank of the Craniofacial and Cleft Care Center (CCCC) at the University Medicine / Göttingen was performed. Data of all non-syndromic CLP patients were collected from the database (Access 2016, Microsoft Windows 10 Pro) who had been treated between August 2001 and December 2021 at the CCCC. The database contained data of 423 patients with cleft deformities of various nature, one hundred forty-nine of whom were “adopted” after treatments performed before August 2001 or previously performed elsewhere and 274 patients treated primarily and completely at the CCCC. Only data from the latter group of patients were evaluated listing date of birth, sex, type of cleft, date and type of surgery, occurrence and location of ONF, date and type of secondary surgery performed for correction of ONF or VPI as well as skeletal surgery at the end of growth. The type of cleft was categorized into cleft lip (CL), cleft lip alveolus (CLA), cleft lip palate (CLP). The cleft palate type was classified according to the system of Veau (Type I: soft palate, Type II: soft and hard palate, Type III: soft and hard palate and unilateral primary palate (UCLP), Type IV: soft and hard palate and bilateral primary palate (BCLP). Submucosal soft palatal clefts were classified as Veau I. A total of 195 patients with non-syndromic CLP and CP were selected for evaluation on the basis of this algorithm. Demographic data on distribution of gender and age are shown in Fig. .Fig. 1Demographic data"