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[Perioperative risk factors evaluation of cleft palate repair in Pierre Robin sequence at early age]
Lian Zhou1, Lian Ma, Rui-chang Liu
1Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
Insights
Cleft palate repair in infants with Pierre Robin sequence (PRS) can cause hypoxemia. Careful management by experienced surgeons can mitigate these perioperative risks for safe early-age repair.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Anesthesiology
Background:
- Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and cleft palate.
- Cleft palate repair in PRS patients presents unique perioperative challenges due to airway obstruction.
- Early surgical intervention is often necessary for proper feeding and development.
Purpose of the Study:
- To identify and evaluate perioperative risk factors associated with cleft palate repair in young patients with Pierre Robin sequence.
- To determine strategies for controlling these identified risk factors to ensure patient safety.
Main Methods:
- A retrospective review of six consecutive patients with PRS undergoing primary cleft palate repair.
- Surgical procedure: von Langenbeck operation performed by a single surgeon.
- Perioperative monitoring included serum oxygen saturation and polysomnographic studies (pre- and post-operative).
Main Results:
- All patients experienced some degree of hypoxemia during intubation.
- Only one patient had hypoxemia in the early post-anesthetic recovery period.
- No significant changes in the apnea-hypopnea index (AHI) were observed before and after surgery.
Conclusions:
- Severe hypoxemia is a significant perioperative risk during cleft palate repair in PRS patients.
- Early cleft palate repair in PRS patients can be performed safely by experienced surgeons.
- Comprehensive consideration and meticulous control of perioperative risk factors are crucial for successful outcomes.
Objective:
To evaluate the perioperative risk factors of the cleft palate repair in Pierre Robin sequence patients at early age and to investigate how to control the risk factors.
Methods:
Six consecutive patients with Pierre Robin sequence underwent primary repair of cleft palate in Department of Oral Maxillofacial Surgery, Peking University School of Stomatology from June 2001 to February 2004. The patients underwent von Longenbeck operation by the same perioperative observation of serum oxygen saturation were obtained for these patients. patients included 4 males and 2 females with age of 9 months to 5 surgeon. Pre- and post-operative polysomnographic studies and years.
Results:
All the patients suffered various degree of hypoxaemia during the period of intubation. There was only one patient who had hypoxaemia within the first 2 hours during postanaesthetic recovery period. No obvious difference was found in apnea and hypopnea index (AHI) among the patients before and after operation.
Conclusions:
Severe hypoxaemia may happen in perioperative period when the patients with PRS underwent cleft palate repair. Most patients with PRS could undergo cleft palate repair safely performed by experienced surgeon at early age under comprehensive consideration and careful control of the risk factors.
