Utilization of the Buccal Fat Pad Flap With Primary Cleft Palate Repair to Improve Speech Outcomes: An Evaluation of Financial Implications

Introduction: Primary cleft palate repair is associated with significant psychosocial burdens for patients and their families. The abundance of operations and appointments create financial and non-financial hardships for the patient and health care system alike. Therefore, the financial implications of cleft care have become an area of focus in craniofacial surgery. The purpose of this study was to evaluate the financial implications of utilization of the buccal fat pad flap (BFPF) during primary cleft palate repair. We hypothesized that utilization of the BFPF as vascularized soft tissue filler would decrease the need for secondary speech operations, therefore decreasing the financial burden of cleft care on patients and the health care system. Methods: A retrospective cohort study was performed that included 146 patients who underwent primary cleft palate repair between 1996 and 2022. Medicare.gov national average costs were utilized to establish standardized direct secondary cleft palate procedural costs, and the total direct and indirect financial cost associated with secondary speech operations was also determined. Results: It was found that usage of the BFPF resulted in a reduction of roughly $1000 in direct secondary procedural costs and a reduction of roughly $3000 in total financial secondary procedural costs for patients. Furthermore, the BFPF’s role in reducing a patient’s need for a secondary speech procedure was reaffirmed with a 15% absolute risk reduction for BFPF patients. Discussion: Overall, cleft palate patients treated with BFPF at the time of initial surgery benefited due to the decreased likelihood of requiring a secondary speech operation as this resulted in a reduction in financial and non-financial costs associated with cleft palate repair, reducing financial toxicity as a whole.