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Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate
Authors:Takemura Hiroshi  Yasumoto Kazumasa  Toi Takashi  Hosoyamada Akiyoshi
Affiliation:Department of Anaesthesiology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan. masuika@med.showa-u.ac.jp
Abstract:
BACKGROUND: A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications. METHODS: We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold. RESULTS: The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05). CONCLUSIONS: Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.
Keywords:infections: upper respiratory    complication: perioperative respiratory    surgery: cleft lip and palate    anaesthesia: infant
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