●Newborns with orofacial clefts are often treated at cleft/craniofacial centers where they receive the full continuum of care from a multidisciplinary team including plastic surgeons, otolaryngologists, speech language pathologists, pediatric dentists, and other specialists.

●The timeline of orofacial cleft care is well described in the literature. It frequently starts with cleft lip repair from the ages of 0 to 6 months.1

●Newborns with a concomitant cleft palate deformity will undergo palatoplasty between 9 to 18 months of age.1

●Following these repairs, speech assessment may reveal hypernasality due to velopharyngeal insufficiency (VPI). Procedures addressing VPI are commonly performed at 4 to 6 years.

●Finally, alveolar bone grafting, which aims to repair a defect in the alveolar process of the maxilla that often accompanies CLP, is performed between 6 to 12 years.1

●While these advised guidelines for the timing of cleft procedures are well-known, it has not yet been described if national surgical practice reflects these recommendations.

●Purpose: To characterize the trends in the timing of six common cleft procedures, to provide a better understanding of how contemporary surgical practice models advised guidelines. We hypothesize that the timing of orofacial operations and reoperations will cluster reliably in discrete time intervals.