Factors Influencing Palatoplasty and Pharyngeal Flap Surgery

Abstract

An experience of 154 patients undergoing palatoplasty or pharyngeal flap surgery at the University of California, Davis, Medical Center (Sacramento) was retrospectively analyzed. There were 114 palatoplasties, 37 pharyngeal flaps, and three combined palatoplasty and pharyngeal flap procedures performed. Factors that could affect postoperative airway compromise, as well as those thought to influence the number of days hospitalized postoperatively, were evaluated using a three-way analysis of covariance. Some degree of airway compromise occurred in 24 patients. The duration of mouth-gag usage strongly correlated with the incidence and severity of airway compromise. Neither steroids nor antibiotics decreased the incidence of respiratory compromise. However, steroids were associated with a decrease in number of days hospitalized (2.7 days vs 4.2 days). The use of intraoperative antibiotics was also associated with a shorter hospitalization (3.5 vs 4.0 days) and with fewer cases of postoperative fever. The high correlation between significant respiratory compromise and duration of mouth-gag usage, as well as clinical observations, suggest that airway compromise in these patients is due to edema of the tongue and related structures secondary to ischemia.