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Respiratory outcomes after cleft palate closure in Robin sequence: a retrospective study

Nathaniel A T Sullivan1,2, Nadia Lachkar3,4, J Peter W Don Griot3,4

  • 1Amsterdam UMC, Department of Plastic Surgery, Location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands. nathanielatsullivan@gmail.com.

Clinical Oral Investigations
|April 11, 2024
PubMed

Insights

Patients with Robin sequence (RS) face higher respiratory complication risks after palate closure compared to isolated cleft palate (ICP). Low preoperative weight and a history of tongue-lip-adhesion (TLA) are key risk factors requiring closer monitoring.

Area of Science:

  • Craniofacial surgery
  • Pediatric respiratory medicine
  • Congenital anomalies

Background:

  • Robin sequence (RS) and isolated cleft palate (ICP) are common congenital conditions affecting oral and facial structures.
  • Obstructive airway complications post-palate closure are a significant concern, particularly in RS patients.
  • Limited data exists on specific risk factors for these complications in RS.

Purpose of the Study:

  • To compare the incidence of respiratory complications after palate closure in patients with RS versus ICP.
  • To identify preoperative risk factors associated with respiratory complications and pediatric intensive care unit (PICU) admission in RS patients.

Main Methods:

  • Retrospective review of 243 consecutive patients with RS and ICP treated over 25 years.
  • Collection of preoperative data including weight, gestational age, previous treatments, and presence of congenital anomalies.
  • Comparison of respiratory complication rates, PICU admissions, and hospital stay duration between RS and ICP groups.

Main Results:

  • Patients with RS were older and had lower gestational age at palate closure compared to ICP.
  • RS patients experienced significantly higher rates of respiratory complications (17% vs 5%), PICU admissions (13% vs 4.1%), and longer hospital stays.
  • A history of tongue-lip-adhesion (TLA) and preoperative weight below 8 kg were identified as significant risk factors for respiratory problems and PICU admission.

Conclusions:

  • Low preoperative weight and a history of TLA are critical risk factors for adverse respiratory outcomes in RS patients undergoing palate closure.
  • Enhanced postoperative surveillance is recommended for RS patients with these identified risk factors.
  • Identifying these risk factors aids clinicians in providing tailored and optimal care for patients with RS.
Abstract

Keywords:
Cleft palateRespiratory distressRisk factorsRobin sequence

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