Main ObjectiveTo analyze postoperative palatoplasty outcomes before and after systemic protocol changes to preferred bottle and arm immobilizer use after surgery.DesignRetrospective, cohort study.SettingUrban, academic, tertiary medical center in New York City, NY.ParticipantsEighty-four patients who underwent primary palatoplasty and met inclusion criteria during 1 of 2 treatment periods, 2016 to 2017 (group A,