Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate

Abstract

Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.

Airway and respiratory complications in children undergoing cleft lip and palate repair

“…A study from Tokyo observed a 4% incidence of respiratory complications in cleft surgeries in infants < 6 months. 1 That study however did not take into account tube-related factors and intubation difficulties. Filles 7 demonstrated an 8.6% incidence of respiratory complications in their series of 174 infants.…”

“…1 We therefore ensured that all our patients were symptomfree, normothermic with normal white cell count and no recent history of cold symptoms.…”

“…1,2 Due to their peculiar paediatric airway, they are prone to difficult airway management and laryngoscopy as well as other airway complications. Bordet 3 demonstrated that airway complications occurred in 7.87% of children under anaesthesia and that the incidence varied with the type of airway device used with laryngeal mask airway(LMA) having the highest incidence of 10.2%, tracheal tube 7.4% and facemask 4.7%.…”

“…1 The purpose of this prospective study was to determine the incidence of intra-operative airway and respiratory related complications during cleft lip and palate repair and to identify risk factor for their occurrence.…”

Perioperative adverse airway events in cleft lip and palate repair

“…3,4 There are a few studies on perioperative complications in cleft lip and palate surgery, but these are largely from developed nations. 3,[5][6][7][8][9] In most developed countries, cleft lip and palate care has evolved into organised cleft teams based in regional or supraregional centres. 1 The situation is different in most developing nations, where lack of trained medical personnel still hinders a high-quality dedicated team approach to delivery of care to orofacial cleft patients.…”