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

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.