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Rates and risks of gastrostomy tubes in infants with cleft palate

Sharon R Cu1, James D Sidman

  • 1Department of Otolaryngology, Children's Hospitals and Clinics of Minnesota and University of Minnesota, Minneapolis, MN, USA.

Archives of Otolaryngology--Head & Neck Surgery
|March 23, 2011
PubMed

Insights

Infants with cleft palate requiring gastrostomy (G)-tubes are significantly more likely to have comorbidities. Specific conditions like respiratory issues dramatically increase G-tube risk, guiding better feeding management strategies.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Genetics

Background:

  • Cleft palate presents feeding challenges in infants.
  • Gastrostomy (G)-tubes are sometimes necessary for nutritional support.
  • Identifying risk factors for G-tube placement is crucial for management.

Purpose of the Study:

  • Determine rates of G-tube placement in infants with cleft palate.
  • Identify comorbidities contributing to G-tube necessity.
  • Analyze relative risks to refine management strategies for feeding difficulties.

Main Methods:

  • Retrospective review of medical records from a tertiary care children's hospital.
  • Included infants with cleft palate born between 2000-2008 without prior G-tubes.
  • Analyzed comorbidities including syndromes/chromosomopathies (syn/chrom) and cardiac, respiratory, neurologic, and GI diagnoses.

Main Results:

  • 34 out of 214 infants with cleft palate required G-tubes.
  • G-tube placement rates varied widely, from 3% (no comorbidity) to 94% (respiratory comorbidity).
  • Relative risks for G-tube placement were significantly elevated with syn/chrom (5.68), single system comorbidity (21.79), and multisystem comorbidities (29.66).

Conclusions:

  • Syndromic/chromosomal diagnoses and major comorbidities significantly increase G-tube placement risk.
  • Cardiac, respiratory, neurological issues, and lower esophageal sphincter problems are key risk factors, often more influential than syn/chrom alone.
  • These findings aid in identifying high-risk infants and optimizing non-surgical feeding interventions before considering G-tubes.
Abstract

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