The Efficacy of Perioperative Steroid Therapy in Pediatric Primary Palatoplasty

Senders, Craig W; Mauro, Stephen M. Di; Brodie, Hilary A.; Emery, Brian E.; Sykes, Jonathan M.

doi:10.1597/1545-1569(1999)036<0340:teopst>2.3.co;2

Cited by 26 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An interesting finding in this study was the propensity for APEs in patients receiving steroids. There are level 1 data reported by Senders et al (1999) and supported by other more recent studies that intravenous perioperative steroids were associated with significantly lower risk of postoperative respiratory distress, shorter time to adequate oral intake, and shorter hospital length of stay (Bateman et al, 2006;Senders et al, 1999). Patients in our study who did not receive steroids had the lowest risk for APEs; however, patients receiving higher doses actually had a lower APE incidence than those getting smaller doses of steroids perioperatively.…”

Section: Ape Risk Model Developmentsupporting

confidence: 78%

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Basta

Fiadjoe

Woo

et al. 2018

The Cleft Palate Craniofacial Journal

View full text Add to dashboard Cite

show abstract

Section: Ape Risk Model Developmentsupporting

confidence: 78%

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Basta

Fiadjoe

Woo

et al. 2018

The Cleft Palate Craniofacial Journal

View full text Add to dashboard Cite

show abstract

“…63 A randomised study to compare 0.25mg/kg steroid on induction to placebo in palatoplasty reported reductions in airway distress and post-operative fever associated with the steroid group. 64 A more recent correspondence described a randomised study of 0.5mg/kg IV dexamethasone on induction in palatoplasty and reported an improvement in oral intake in the steroid group. 65…”

Section: Discussionmentioning

confidence: 99%

“…63 A randomised study to compare 0.25mg/kg steroid on induction to placebo in palatoplasty reported reductions in airway distress and post-operative fever associated with the steroid group. 64 A more recent correspondence described a All rights reserved. No reuse allowed without permission.…”

Section: Adjunctsmentioning

confidence: 99%

Current surgical practice for children born with a cleft lip and/or palate in the United Kingdom

Fell

Davies²,

Davies

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: This study describes primary surgical reconstructions performed for children born with a cleft lip and/or palate in the United Kingdom. Methods: Data were obtained from the Cleft Collective, a national longitudinal cohort study. Data forms completed at the time of surgery included details on timing, technique and adjuncts used during the operative period. Demographic data on participants were validated via parental questionnaires. Results: Between 2015 and 2021, 1782 Cleft Collective surgical forms were included, relating to the primary reconstructions of 1514 individual children. The median age at primary cheiloplasty was 4.3 months. Unilateral cleft lips were reconstructed with an anatomical subunit approximation technique in 53%, whereas bilateral cleft lips were reconstructed with a broader range of eponymous techniques. Clefts of the soft palate were reconstructed at a median age of 10.3 months with an intravelar veloplasty in 94% cases. Clefts of the hard palate were reconstructed with a vomer flap in 84% cases in a bi-modal age distribution, relating to reconstruction carried out simultaneously with either lip or soft palate reconstruction. Antibiotics were used in 96% of cases, with an at-induction-only regimen used more commonly for cheiloplasties (p<0.001) and a 5 to 7day post-operative regime used more commonly for soft palatoplasties (p<0.001). Peri-operative steroids were used more commonly in palatoplasties than cheiloplasties (p<0.001) but tranexamic acid use was equivalent (p=0.73). Conclusion: This study contributes to our understanding of current cleft surgical pathways in the United Kingdom and will provide a baseline for analysis of the effectiveness of utilised protocols.

show abstract

“…surgeons should be aware of an increased risk of perioperative airway compromise (particularly hypoxemia after extubation) [24][25][26]. In the palatoplasty postoperative setting, 39 and 43% of surgeons discharged their palate patients within 24 and 48 h after surgery, respectively [27].…”

Section: Key Pointsmentioning

confidence: 99%

Update on outcomes research for cleft lip and palate

Shaye

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

View full text Add to dashboard Cite

The literature lacks any evidence-based consensus to support a superior method of cleft lip repair. A majority of North American surgeons, however, utilize a rotation-advancement technique and perform cleft rhinoplasty at the time of primary lip repair, with the idea that this could decrease the number of revision surgeries needed over the long term. Most cleft surgeons perform a single-stage palatoplasty at 9-12 months of age for improved early speech outcomes. There is insufficient evidence to support a two-stage palatoplasty with the intention of improved maxillary growth. Controversy persists on the relationship between early palatal surgery and its deleterious effects on facial development. A shift toward patient-reported outcomes is called for; however, this remains difficult, as there are few validated, cleft-specific outcome measurement tools.

show abstract

The Efficacy of Perioperative Steroid Therapy in Pediatric Primary Palatoplasty

Abstract: Perioperative steroids effectively lower the risk of postoperative airway distress and postoperative fever in children undergoing the primary repair of their cleft palate. This finding favors a customary role for perioperative steroid therapy in pediatric primary palatoplasty.

Cited by 26 publications

References 0 publications

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Current surgical practice for children born with a cleft lip and/or palate in the United Kingdom

Update on outcomes research for cleft lip and palate

Contact Info

Product

Resources

About