Perioperative complications in infant cleft repair

Thomas Fillies,Christoph Homann,Ulrich Meyer,Richard Werkmeister,Alexander Reich,Ulrich Joos

doi:10.1186/1746-160x-3-9

Abstract

BackgroundCleft surgery in infants includes special risks due to the kind of the malformation. These risks can be attributed in part to the age and the weight of the patient. Whereas a lot of studies investigated the long-term facial outcome of cleft surgery depending on the age at operation, less is known about the complications arising during a cleft surgery in early infancy.MethodsWe investigated the incidence and severity of perioperative complications in 174 infants undergoing primary cleft surgery. The severity and the complications were recorded during the intraoperative and the early postoperative period according to the classification by Cohen.ResultsOur study revealed that minor complications occurred in 50 patients. Severe complications were observed during 13 operations. There was no fatal complication in the perioperative period. The risk of complications was found to be directly correlated to the body weight at the time of the surgery. Most of the problems appeared intraoperatively, but they were also followed by complications immediately after the extubation.ConclusionIn conclusion, cleft surgery in infancy is accompanied by frequent and sometimes severe perioperative complications that may be attributed to this special surgical field.

Highlights

Cleft surgery in infants includes special risks due to the kind of the malformation
In conclusion, cleft surgery in infancy is accompanied by frequent and sometimes severe perioperative complications that may be attributed to this special surgical field
Gunawardana [12] prospectively studied 800 pedriatric patients undergoing a repair of a cleft lip and palate in order to determine the factors that are predictive of difficult laryngoscopy

Summary

Introduction

Cleft surgery in infants includes special risks due to the kind of the malformation. These risks can be attributed in part to the age and the weight of the patient. Surgical treatment of clefts during the infancy is a particular challenge for the maxillo-facial surgeon and for the anaesthesiologist. Young infants possess anatomical particularities which can cause problems during the cleft treatment. The enhanced incidence of anaesthesiological complications in children with cleft lip and palate (CLP) can be attributed to various factors such as a higher viscid airway resistance, a higher incidence of respiratory infections, nutritional deficiencies, developmental anomalies and anatomical features like micrognathia, macroglossia and jaw-bone hyoplasia. In cleft lip and/or palate patients the anomaly requiring sur-

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Results

Conclusion