PONE-D-22-24340Trends of cleft surgeries and predictors of late primary surgery among children with cleft lip and palate at the University College Hospital, Nigeria: a retrospective cohort studyPLOS ONE

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Johari Yap Abdullah, B.S. & I.T, GradDip ICT, M.Sc, Ph.D.

Academic Editor

PLOS ONE

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Reviewer #1: Partly

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

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Reviewer #1: Dear Authors

1.Tertiary Hospital or Hospital University usually have their own " cleft team" which comprises of surgeons, orthodontist, geneticist, audiologist, dentist and others. Is there any cleft team was formed at your hospital? as this will offers a comprehensive treatments and follow up to the patients.

The hazard of delay in primary repair of cleft are not mentioned in the manuscript although statistical analysis of relationship between the types of cleft and hazard of delay in primary repair was mentioned. What are the hazard involved?

This study is a retrospective study, there were a significant data from follow up sessions that can support the changing trends of surgical procedures, with the supported data, authors can conclude the reasons of the changes of surgical trends whether it is based on surgical defects or observable complications and advantages of that particular surgical techniques.

"The nature of the data base used for this research

does not allow for relating the changing trend in the methods of cleft lip and palate repair to

outcomes of repair." Even though authors clearly state the limitation, to absolutely determined the factors that change the surgical approaches, the data related to preoperative assessment, postoperative follow up to compare which surgical approaches causes less complications must be included if the authors really wanted to determine the changing trends of cleft surgical procedures.

For the patients with cleft lip and palate treated at your center, any pre-surgical orthodontic treatment such as Nasoalveolar Molding( NAM) appliances were offered to patients as this will determine surgical approaches that will be provided by the surgeons.

The second and third objectives of this study were well elaborated by the authors.

2. The statistical anaylsis for this study has been performed appropriately.

3. All data underlying the findings are fully available in the manuscript.

4. There are a lot of spelling errors particularly the surgical procedures.

Abstract

Subheading

Result

a) Bardachs two flap palatoplasty has replaced Von Lagenbeck palatoplasty as the

commonest method of palatal repair- Von Langenbeck

Conclusion

a)There has been a change from Von Lagenbeck palatoplasty to Bardachs two-flap palatoplasty- Von Langenbeck

Introduction

Subheading

Trends in methods of cleft lip and palate repair

Spelling error of Von Langenbeck

the "Von Lagenbeck" procedure should be corrected for each of the mentioned sentences to " Von Langenbeck"

Subheading Discussion

Spelling error

"Although the Von lagenbecks palatoplasty was method more commonly employed

for closure of cleft palate the trend showed that tis method had been completely abandoned in the

last six years of the study period and replaced with the two flap palatoplasty technique by

Bardach. This may probably reflect a change in surgeon dynamics and knowledge oge of

palatoplasty techniques as well as the advantages the Bardachs’s palatoplasty has over Von

Lagenbacks palatoplasty"

Surgical technique and tis should be change to this.

Knowlegde oge to knowledge of.

please consider to proof read your manuscript before the submission.

Reviewer #2: The manuscript is well written, need a minor revision.

1. Surgical procedures should be well planned to reduce exposure to anaesthesia from multiple surgeries (3) (One reference is not sufficient to support this statement. Add few more references. The different surgical techniques must also be included)

2. The procedure of obtaining informed consent is not mentioned. Kindly elaborate the informed consent procedure (Study design and setting)

3. Only primary surgeries of typical clefts were utilized for bivariate and multivariable a analysis to determine the primary outcomes, as such atypical clefts and secondary surgeries were not analyzed further (Rewrite the sentences)

4. Further explanation is needed in terms of advancement in latest trends of cleft surgeries. For example, Bardach's technique and other techniques must need a detailed explanation. (Add a new paragraph before Prevalence and hazards of late repairs section.

5. Reference format is not proper. Please refer to ICMJE format for standard journal article

6. The figures must be uploaded in 300 dpi format. (Refer to author guidelines for figures)

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Reviewer #1: No

Reviewer #2: Yes: Mohamed Zahoor Ul Huqh

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Attachments

Attachment

Submitted filename: PONE-D-22-24340_reviewer01.pdf

Trends of cleft surgeries and predictors of late primary surgery among children with cleft lip and palate at the University College Hospital, Nigeria: a retrospective cohort study

PONE-D-22-24340R1

Dear Dr. Michael,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Johari Yap Abdullah, B.S. & I.T, GradDip ICT, M.Sc, Ph.D.

Academic Editor

PLOS ONE

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