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Intensive Care Unit Admission Following Cleft Palate Repair in Patients With Pierre Robin Sequence Corrected With
Shelby D Goza1, Katherine E Baker1, Madyson I Brown1
1University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, Jackson, Mississippi.
Eplasty
|July 15, 2025
Summary
Pediatric patients with Pierre Robin Sequence (PRS) who underwent mandibular distraction (MD) and cleft palate (CP) repair generally do not require pediatric intensive care unit (PICU) admission, indicating floor care is often safe post-surgery.
Area of Science:
- Craniofacial surgery
- Pediatric surgery
- Airway management
Background:
- Pierre Robin Sequence (PRS) patients often have cleft palate (CP) and undergo mandibular distraction (MD).
- Standardized protocols for pediatric intensive care unit (PICU) admission post-CP repair in these patients are lacking.
- This study evaluates airway events after CP repair in PRS patients with prior MD.
Purpose of the Study:
- To determine the frequency of airway events following cleft palate repair in patients with Pierre Robin Sequence who have undergone mandibular distraction.
- To assess the safety and necessity of pediatric intensive care unit admission after cleft palate repair in this specific patient population.
Main Methods:
- Retrospective chart review of PRS patients (2012-2022) who had both MD and CP repair.
- Data collected included: analgesic use, respiratory status, comorbidities, and operative details.
- Primary outcomes: length of stay, airway events, and PICU admission post-CP repair.
Main Results:
- Out of 13 patients who underwent CP repair post-MD, only 2 experienced airway events.
- Just 3 patients required PICU admission; comorbidities were associated with PICU need.
- Longer intubation post-MD correlated with PICU admission and prolonged post-CP repair intubation.
Conclusions:
- CP repair in PRS patients with a history of MD appears safe for floor admission.
- Comorbidities and prolonged intubation are key factors influencing PICU admission decisions.
