SpringerLink
Log in

Postoperative Management of Cleft Palate Repair

  • Living reference work entry
  • First Online:
Surgical Atlas of Cleft Palate and Palatal Fistulae

  • 29 Accesses

Abstract

Successful surgical repair of a congenital cleft palate requires a comprehensive postoperative care plan that proactively seeks to mitigate both early and late surgical complications. While early postoperative complications of airway compromise and bleeding are rare, they can be life threatening. A palatal fistula is a late complication of cleft palate repair that can cause significant functional impairment and need for additional repair. Assessment of the patient’s individual risk factors is crucial to development of a comprehensive postoperative plan following cleft palate repair.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  • Antony AK, Sloan GM (2002) Airway obstruction following palatoplasty: analysis of 247 consecutive operations. Cleft Palate Craniofac J 39:145–148

    Article  Google Scholar 

  • Aznar ML, Schonmeyr B, Echaniz G, Nebeker L, Wendby L, Campbell A (2015) Role of postoperative antimicrobials in cleft palate surgery: prospective, double-blind, randomized, placebo-controlled clinical study in India. Plast Reconstr Surg 136:59e–66e

    Article  CAS  Google Scholar 

  • Bykowski MR, Naran S, Winger DG, Losee JE (2015) The rate of oronasal fistula following primary cleft palate surgery: a meta-analysis. Cleft Palate Craniofac J 52:e81–e87

    Article  Google Scholar 

  • Chaya BF, Chalhoub R, Jaafar R, Nahhas N, Abu-Sittah G (2020) Prevalence of stunting in Syrian refugee children with cleft lip and/or cleft palate in time of crisis: a call for intervention. Cleft Palate Craniofac J 57:1166–1170

    Article  Google Scholar 

  • Chiono J, Raux O, Bringuier S, Sola C, Bigorre M, Capdevila X, Dadure C (2014) Bilateral suprazygomatic maxillary nerve block for cleft palate repair in children: a prospective, randomized, double-blind study versus placebo. Anesthesiology 120:1362–1369

    Article  CAS  Google Scholar 

  • Chung KT, Wong TY, Wei CI, Huang YW, Lin Y (1998) Tannins and human health: a review. Crit Rev Food Sci Nutr 38:421–464

    Article  CAS  Google Scholar 

  • Costa MA, Murage KP, Tholpady SS, Flores RL (2014) Airway compromise following palatoplasty in Robin sequence: improving safety and predictability. Plast Reconstr Surg 134:937e–945e

    Article  CAS  Google Scholar 

  • Daniels KM, Yu EY, Maine RG, Corlew S, Bing S, Hoffman WY, Gregory GA (2015) Palatal fistula risk after primary palatoplasty: a retrospective comparison of humanitarian operations and tertiary hospitals. Lancet 385(Suppl 2):S37

    Article  Google Scholar 

  • Dorfman DW, Ciminello FS, Wong GB (2010) Tongue suture placement after cleft palate repair. J Craniofac Surg 21:1601–1603

    Article  Google Scholar 

  • Gallagher S, Ferrera A, Spera L, Eppley BL, Soleimani T, Tahiri Y, Sood R, Flores RL, Wooden WA, Tholpady SS (2016) Utility of tongue stitch and nasal trumpet in the immediate postoperative outcome of cleft Palatoplasty. Plast Reconstr Surg 137:569–573

    Article  CAS  Google Scholar 

  • Hardwicke JT, Landini G, Richard BM (2014) Fistula incidence after primary cleft palate repair: a systematic review of the literature. Plast Reconstr Surg 134:618e–627e

    Article  CAS  Google Scholar 

  • Jackson O, Basta M, Sonnad S, Stricker P, Larossa D, Fiadjoe J (2013) Perioperative risk factors for adverse airway events in patients undergoing cleft palate repair. Cleft Palate Craniofac J 50:330–336

    Article  Google Scholar 

  • Kaye A, Che C (2019) Differences in weight loss and recovery after cleft lip and palate repair. Cleft Palate Craniofac J 56:196–203

    Article  Google Scholar 

  • Kocaaslan FND, Sendur S, Kocak I, Celebiler O (2020) The comparison of Pierre Robin sequence and non-syndromic cleft palate. J Craniofac Surg 31:226–229

    Article  Google Scholar 

  • Kuyt FC, Amoako E (2021) Optimizing postoperative pediatric and nursing care. In: Swanson JW (ed) Global cleft care in low-resource settings. Springer, Cham. https://doi.org/10.1007/978-3-030-59105-2_31

    Chapter  Google Scholar 

  • Lee A, Chang BL, Yan C, Fox JP, Magee L, Scott M, Maguire MA, Ross K, Rakow C, Drake F, McGinnis A, Watson A, Burlingame C, Kraemer FW, Muhly WT, Ruby J, Jackson OA (2020) The reducing opioid use in children with clefts protocol: a multidisciplinary quality improvement effort to reduce perioperative opioid use in patients undergoing cleft surgery. Plast Reconstr Surg 145:507–516

    Article  CAS  Google Scholar 

  • Maine RG, Hoffman WY, Palacios-Martinez JH, Corlew DS, Gregory GA (2012) Comparison of fistula rates after palatoplasty for international and local surgeons on surgical missions in Ecuador with rates at a craniofacial center in the United States. Plast Reconstr Surg 129:319e–326e

    Article  CAS  Google Scholar 

  • Nour C, Ratsiu J, Singh N, Mason L, Ray A, Martin M, Hassanian M, Uhler J, Applegate RL 2nd (2014) Analgesic effectiveness of acetaminophen for primary cleft palate repair in young children: a randomized placebo controlled trial. Paediatr Anaesth 24:574–581

    Article  Google Scholar 

  • Preidl RHM, Kesting M, Rau A (2020) Perioperative management in patients with cleft lip and palate. J Craniofac Surg 31:95–101

    Article  Google Scholar 

  • Raghavan U, Vijayadev V, Rao D, Ullas G (2018) Postoperative management of cleft lip and palate surgery. Facial Plast Surg 34:605–611

    Article  CAS  Google Scholar 

  • Roode GJ, Butow KW, Naidoo S (2017) Preoperative evaluation of micro-organisms in non-operated cleft in soft palate: impact on use of antibiotics. Br J Oral Maxillofac Surg 55:127–131

    Article  CAS  Google Scholar 

  • Rossell-Perry P, Segura E, Salas-Bustinza L, Cotrina-Rabanal O (2015) Comparison of two models of surgical care for patients with cleft lip and palate in resource-challenged settings. World J Surg 39:47–53

    Article  Google Scholar 

  • Rottgers SA, Camison L, Mai R, Shakir S, Grunwaldt L, Nowalk AJ, Natali M, Losee JE (2016) Antibiotic use in primary palatoplasty: a survey of practice patterns, assessment of efficacy, and proposed guidelines for use. Plast Reconstr Surg 137:574–582

    Article  CAS  Google Scholar 

  • van Lieshout MJ, Voshol IE, Joosten KF, van der Schroeff MP, Mathijssen IM, Koudstaal MJ, Wolvius EB (2016) Respiratory distress following cleft palate repair in children with Robin sequence. Cleft Palate Craniofac J 53:203–209

    Article  Google Scholar 

  • Weber CR, Griffin JM (1994) Evaluation of dexamethasone for reducing postoperative edema and inflammatory response after orthognathic surgery. J Oral Maxillofac Surg 52:35–39

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cleft and Craniofacial Program, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Rachel A. McKenna, Christopher L. Kalmar & Jordan W. Swanson

Authors
  1. Rachel A. McKenna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher L. Kalmar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jordan W. Swanson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel A. McKenna .

Editor information

Editors and Affiliations

  1. Plastic Surgery, Services Institute of Medical Sciences, Lahore, Pakistan

    Ghulam Qadir Fayyaz

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

McKenna, R.A., Kalmar, C.L., Swanson, J.W. (2022). Postoperative Management of Cleft Palate Repair. In: Fayyaz, G.Q. (eds) Surgical Atlas of Cleft Palate and Palatal Fistulae. Springer, Singapore. https://doi.org/10.1007/978-981-15-3889-6_50-1

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-3889-6_50-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-3889-6

  • Online ISBN: 978-981-15-3889-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation