Seasonal variation in the incidence of oronasal fistula following primary palatoplasty

Relevance. Disease seasonality, particularly that of infectious diseases, has been extensively studied. Associations between the timing of surgery within the calendar year and certain surgical complications have been reported; however, the potential association between the time of year when palatoplasty is performed and early postoperative complications remains insufficiently studied. Objective. To retrospectively analyze the potential association between the calendar month in which palatoplasty was performed and the incidence of postoperative complications, particularly oronasal fistula (ONF) formation. Materials and methods. This retrospective study evaluated early anatomical outcomes in 339 patients with cleft palate who underwent surgical treatment at a medical center in St. Petersburg over a 60-month period. Statistical analysis examined the association between postoperative complications and month of surgery. Results. Pearson’s χ2 test showed no statistically significant association between month of surgery and the incidence of complications (χ2 = 14.52; df = 11; p = 0.205). However, logistic regression analysis with January as the reference category showed significantly higher odds of complications in May (p = 0.028) and an overall trend toward a higher complication rate in spring. No other month differed significantly from January. Conclusion. When scheduling palatoplasty, regional seasonal variation should be considered a potential risk factor for postoperative complications.

1. Chuykin S.V., Davletshin N.A., Kuchuk K.N., Chuykin O.S., Grin E.A., Muratov A.M. Analusisis of results and complications uranoplasty in children with congenital cleft lip and palate. Actual problems in dentistry. 2020;16(1):133-138 (In Russ.). https://doi.org/10.18481/2077-7566-20-16-1-133-138

2. Mason K, Kotlarek K, Davies A, Wren Y. Beyond prevalence: understanding the relationship between early anatomic factors and the likelihood for cleft speech characteristics. Int J Lang Commun Disord. 2025;60(6):e70152. https://doi.org/10.1111/1460-6984.70152

3. Chuykin O.S., Bilak A.G., Kuchuk K.N., Davletshin N.A., Dyumeev R.M., Akat’yeva G.G., et al. Characteristics of complications of uranoplasty in children with congenital cleft palate. Actual problems in dentistry. 2024;(2):168-171 (In Russ.). https://doi.org/10.18481/2077-7566-2024-20-2-168-171

4. Park MS, Seo HJ, Bae YC. Incidence of fistula after primary cleft palate repair: a 25-year assessment of one surgeon's experience. Arch Plast Surg. 2022;49(1):43-49. https://doi.org/10.5999/aps.2021.01396

5. Wu M, Yin H, Chen L, Shi B, Li Y. Analysis of risk factors affecting poor wound healing after primary cleft palate surgery. Hua Xi Kou Qiang Yi Xue Za Zhi. 2023;41(6):719-724. https://doi.org/10.7518/hxkq.2023.2023117

6. Mitropanova M.N. Features of immunological system functioning in children with cleft lip and palate during surgical stage of treatment. Pediatric dentistry and dental prophylaxis. 2017;16(61):79-83 (In Russ.). Available from: https://www.detstom.ru/jour/article/view/67

7. Paatela E, Munson D, Kikyo N. Circadian regulation in tissue regeneration. Int J Mol Sci. 2019;20(9):2263. https://doi.org/10.3390/ijms20092263

8. Anokhin PK. Philosophical aspects of the theory of a functional system. Russ Stud Philos. 1971;10(3):269–276 https://doi.org/10.2753/RSP1061-19671003269

9. Martinez ME. The calendar of epidemics: seasonal cycles of infectious diseases. PLoS Pathog. 2018;14(11):e1007327. https://doi.org/10.1371/journal.ppat.1007327

10. Datieva FS. Currert aspects of human chronoadaptation and desasaptation. Bashkortostan medical newsletter. 2021;16(6):71-78 (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=48693563

11. Hrivnakova J, Fara M, Chlupackova V. Complications of healing after primary repair of cleft lip and palate: evaluation of 1000 cases. Plast Reconstr Surg. 1969;44(1):97. Available from: https://journals.lww.com/plasreconsurg/citation/1969/07000/complications_of_healing_after_primary_repair_of.44.aspx