Utility of Tongue Stitch and Nasal Trumpet in the Immediate Postoperative Outcome of Cleft Palatoplasty

Gallagher, Sidhbh; Ferrera, Alessandra G.; Spera, Leigh J; Eppley, Barry L.; Soleimani, Tahereh; Tahiri, Youssef; Sood, Rajiv; Flores, Roberto L.; Wooden, William A.; Tholpady, Sunil S.

doi:10.1097/01.prs.0000475786.60069.a3

Cited by 13 publications

(4 citation statements)

References 10 publications

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“…Specifically, airway protective measures such as the tongue stitch and/or nasal trumpet, as well as planned pediatric ICU admission, are potential risk-reducing interventions commonly used after cleft palate repair. However, there are no guidelines delineating specific indications for either intervention (Basta et al, 2016; Gallagher et al, 2016). To provide the safest and most effective care, a more selective approach targeting only higher risk patients is necessary and requires individualized risk stratification tools such as that presented here.…”

Section: Discussionmentioning

confidence: 99%

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Basta

Fiadjoe

Woo

et al. 2018

The Cleft Palate-Craniofacial Journal

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Section: Discussionmentioning

confidence: 99%

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Basta

Fiadjoe

Woo

et al. 2018

The Cleft Palate-Craniofacial Journal

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“…161,162 Surgical correction of malocclusion typically involves LeFort I osteotomies for maxillary advancement and repositioning; bilateral sagittal split osteotomies may also be necessary in secondary mandibular defects caused by hyperplastic condyles. 113 Recently, osteogenic distraction of the maxilla has been published as an alternative to, or in preparation for, conventional orthognathic surgery. [163][164][165] Maxillary anterior segmental distraction osteogenesis (MASDO) uses intraoral tooth-borne distractors with miniscrews to advance only the anterior maxillary segment.…”

Section: Orthognathic Surgerymentioning

confidence: 99%

“…In syndromic or high-risk patients, nasopharyngeal airways (nasal trumpets) or a tongue stitch may be placed to decrease the risk of airway obstruction. 87,113 The perioperative use of dexamethasone has proven effective in reducing the risk of postoperative respiratory distress and fever in children undergoing primary palatoplasty. 114 Pain control is an important aspect of postoperative cleft care.…”

Section: Postoperative Care and Complicationsmentioning

confidence: 99%

Updates in Cleft Care

Parham,

Simpson,

Moreno

et al. 2023

Semin Plast Surg

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Cleft lip and/or palate is a congenital malformation with a wide range of presentations, and its effective treatment necessitates sustained, comprehensive care across an affected child's life. Early diagnosis, ideally through prenatal imaging or immediately postbirth, is paramount. Access to longitudinal care and long-term follow-up with a multidisciplinary approach, led by the recommendations of the American Cleft Palate Association, is the best way to ensure optimal outcomes. Multiple specialties including plastic surgery, otolaryngology, speech therapy, orthodontists, psychologists, and audiologists all may be indicated in the care of the child. Primary repair of the lip, nose, and palate are generally conducted during infancy. Postoperative care demands meticulous oversight to detect potential complications. If necessary, revisional surgeries should be performed before the child begin primary school. As the child matures, secondary procedures like alveolar bone grafting and orthognathic surgery may be requisite. The landscape of cleft care has undergone significant transformation since early surgical correction, with treatment plans now tailored to the specific type and severity of the cleft. The purpose of this text is to outline the current standards of care in children born with cleft lip and/or palate and to highlight ongoing advancements in the field.

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“…A tongue stich or nasal trumpets can also be placed by the surgeon following CP repair to relieve obstruction should it result. These techniques are not uniformly used by cleft teams in the United States [42] and there is no increase in reintubation rates when tongue stitch is avoided [43], but it is our practice to place a tongue stitch on all our CP patients. The tongue stitch remains in place while the patient is in the PACU, but is removed before transfer to a medical floor for monitoring overnight.…”

Section: Postoperative Carementioning

confidence: 99%

Pediatric Anesthesia for Patients with Cleft Lip and Palate

Brzenski¹,

Ham-Mancilla²,

Peña-Olvera³

et al. 2019

Anesthesia Topics for Plastic and Reconstructive Surgery

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Cleft lip and palate are the most common craniofacial deformities in the United States of America and México. Their aesthetic and functional implications influence the lifestyle of the patient: social relationships, school and working performances, self-esteem and health. Surgical repair of the cleft lip is around the third to sixth month of age and the palate repair is when the patient is between six and eighteen months old. There are other surgical repairs during childhood and ideally all of them should be performed by an experienced surgeon teaming up with a pediatric anesthesiologist following the gold standards in cleft care, in a setting where the safety of the patient is paramount.

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Utility of Tongue Stitch and Nasal Trumpet in the Immediate Postoperative Outcome of Cleft Palatoplasty

Abstract: Therapeutic, III.

Cited by 13 publications

References 10 publications

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Updates in Cleft Care

Pediatric Anesthesia for Patients with Cleft Lip and Palate

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