Severe Glossal Edema After Primary Palatoplasty

Abstract

At most American centers, primary palatoplasty to repair a cleft palate is generally performed in patients by the age of 12 months to allow for appropriate speech development. Surgical access for the palatoplasty is often obtained with a Dingman mouth gag, which allows for maximum access and visibility of the surgical field. There are multiple techniques used by cleft surgeons to repair cleft palates, including War-dill-Kilner, von Langenbeck, Bardach, and Furlow Z-plasty. Common complications of these procedures in the immediate postoperative phase include bleeding and oropharyngeal edema. Airway obstruction is rare and most commonly results from laryngeal edema from a traumatic intubation. This case report documents severe glossal edema immediately after primary palatoplasty, causing airway obstruction and requiring reintubation in the immediate postoperative period. This is a rarely documented complication of palatoplasty, with only 4 reports noted in the medical literature since 1950, 3 in the anesthesia literature and 1 in the surgical literature. 1-4 .