Related Experiment Video

Updated: Jun 13, 2025

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
06:13

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

16.7K

Postoperative respiratory difficulties following primary cleft palate repair in infants with Robin sequence versus

Shirley van de Velde1, Merel M Smit1, Robrecht J H Logjes1

  • 1Department of Pediatric Plastic and Reconstructive Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital, Lundlaan 6, 3584 EA, Utrecht, the Netherlands.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|September 10, 2024
PubMed

Insights

Infants with Robin sequence (RS), particularly non-isolated RS, face a higher risk of postoperative respiratory difficulties (PRD) after cleft palate repair (CPR). Preoperative palatal plate analysis showed limited predictive value for PRD in these infants.

Area of Science:

  • Pediatric Surgery
  • Craniofacial Anomalies
  • Respiratory Medicine

Background:

  • Cleft palate repair (CPR) is a common surgical procedure in infants.
  • Postoperative respiratory difficulties (PRD) are a known complication.
  • Robin sequence (RS) presents unique challenges due to airway anatomy.

Purpose of the Study:

  • Compare PRD incidence after primary CPR between isolated cleft palate (iCP) and Robin sequence (RS) infants.
  • Evaluate the utility of preoperative palatal plate analysis in RS infants.
  • Identify risk factors for PRD in infants undergoing CPR.

Main Methods:

  • Retrospective review of infants undergoing primary CPR from January 2009 to June 2022.
  • Inclusion of infants with iCP and RS (further categorized into non-isolated RS [niRS] and isolated RS [iRS]).
  • Statistical analysis to compare PRD rates and assess the impact of palatal plate screening.

Main Results:

  • Infants with RS exhibited significantly higher PRD rates compared to iCP infants (14/53 vs. 9/74, p=0.04).
  • Infants with niRS had a significantly higher risk of PRD versus iCP infants (OR=4.16, p=0.031).
  • Preoperative palatal plate screening in RS infants (n=25) revealed no abnormalities and did not alter perioperative management or predict PRD.

Conclusions:

  • Infants with niRS are more susceptible to PRD following primary CPR than iRS or iCP infants.
  • Postponing CPR in RS infants to avoid PRD showed no clear benefit.
  • Preoperative palatal plate analysis has low predictive value for identifying RS infants at risk of PRD.

Keywords:
Cleft palateCleft palate repairObstructive sleep apneaRespiratory difficultiesRobin sequenceUpper airway obstruction

More Related Videos

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation04:46

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

21.5K
Method of Studying Palatal Fusion using Static Organ Culture04:58

Method of Studying Palatal Fusion using Static Organ Culture

Published on: September 19, 2015

8.7K

Related Concept Videos

Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.5K
Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
309
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
126
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
473
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
136
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
162