| Description: |
Objective To evaluate factors impacting access to and timing of surgery in patients with submucous cleft palate (SMCP) and velopharyngeal dysfunction (VPD). Study Design Retrospective cohort study. Setting Single academic medical center. Methods Patients with SMCP and VPD between 2004 and 2021 were identified. Variables included national and state area deprivation index (ADI) percentiles, child opportunity index (COI) categories, distance to care, and insurance status. χ 2 , Fisher's exact test, Wilcoxon rank‐sum, Spearman rank correlation, t test, and linear regression ( α = .05) were used to investigate the relationships between these variables and surgical status and timing. Results A total of 168 patients were included, 94 surgical and 74 nonsurgical. Patients were predominantly white (160/168; 95.2%), Male (103/168; 61.3%), and non‐Hispanic (153/168; 91.1%). There were no intergroup differences with respect to ADI, COI, insurance status, or distance from the hospital. Surgical patients were more likely to have overt SMCP ( P = .03), earlier age at SMCP diagnosis ( P = .02), and higher baseline Pittsburgh weighted speech score (PWSS) ( P = |