Cleft Palate Demographics and Complications: A Single-Center Study in Baghdad, Iraq

Abstract

Background: Cleft palate (CP), with or without cleft lip (CL), is one of the most common congenital orofacial anomalies and is associated with functional, otologic, and surgical complications. Despite global literature on CP, data from Iraq—particularly regarding demographics and postoperative complications—remain limited.

Objective: To evaluate the demographic characteristics and postoperative complications of cleft palate patients treated in one of Baghdad’s hospitals, with particular focus on fistula formation, infection, and otitis media, and their relationship to age, gender, and timing of surgery.

Methods: This retrospective study included 34 patients who underwent cleft palate repair at Al-Karkh General Hospital, Baghdad, through the period of more than 8 months from October 2024 to July 2025 and then continued on follow-up. Demographic data, age at surgery, and postoperative complications were recorded. Surgical techniques primarily included von Langenbeck’s bipedicled flaps and Bardach’s two-flaps technique, with vomer flaps used for wide clefts.

Results: The study population consisted of 55.9% males and 44.1% females, with most patients aged between 6 months and 6 years (mean age ≈ 39 months). Gender and age group distributions showed no significant deviation from randomness (P>0.05). In contrast, timing of surgery demonstrated a highly significant tendency toward early intervention, with 50% of cases operated on before 6 months of age (P<0.01). Postoperative complications were infrequent: fistula (15%), infection (6%), and otitis media (9%), all showing highly significant restricted distributions toward negative outcomes (P<0.01). Although no statistically significant associations were identified between complications and demographic variables, clinically relevant trends suggested higher fistula rates in older children and increased otitis media in younger patients, particularly males.

Conclusion: Cleft palate patients treated at this Baghdad hospital demonstrated low rates of postoperative complications, likely reflecting early diagnosis and timely surgical management. While most demographic factors showed no statistically significant associations with complications, observed clinical trends emphasize the importance of early intervention and careful postoperative follow-up. Larger, multicenter studies are recommended to further elucidate demographic and clinical predictors of outcomes in Iraqi cleft palate populations.