Document Detail


Can we predict a difficult intubation in cleft lip/palate patients?
MedLine Citation:
PMID:  22420397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To find predictors of a difficult intubation in infants with an isolated or a syndromic cleft lip/palate.
STUDY DESIGN: Retrospective review: single-blind trial.
SETTINGS: Tertiary care centre.
METHODS: A total of 145 infants born with cleft lip/palate were enrolled. Three clinical and seven lip/palate anatomic parameters were evaluated. The grade of intubation was determined by the anesthesiologist at the time of the labioplasty/staphylorrhaphy surgery at 3 and 10 months, respectively.
MAIN OUTCOME MEASURE: Intubation grade.
RESULTS: The relative risk of a difficult intubation in the cleft lip, cleft palate without the Pierre Robin sequence, cleft lip-palate, and cleft palate with Pierre Robin sequence groups was 0, 2.7, 10, and 23%, respectively. The infants born with the Pierre Robin sequence had a statistically significant higher intubation grade. The degree of difficulty was increased in cases with early airway and feeding problems (p < .0001). Within the group of cleft palate patients without any lip malformation, a wider cleft was associated with a higher intubation grade with statistical significance (p  =  .0323).
CONCLUSIONS: Infants born with Pierre Robin sequence have a statistically significantly higher risk of difficult intubation. Within this group, of all the studied factors, a clinical history of early airway and feeding problems was the best predictor of a difficult endotracheal intubation. In cleft palate patients without any cleft lip, larger width of the cleft is also a significant predictor.
Authors:
Isabelle Arteau-Gauthier; Jacques E Leclerc; Audrey Godbout
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale     Volume:  40     ISSN:  1916-0216     ISO Abbreviation:  J Otolaryngol Head Neck Surg     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2012-03-16     Completed Date:  2012-09-14     Revised Date:  2013-04-10    
Medline Journal Info:
Nlm Unique ID:  101479544     Medline TA:  J Otolaryngol Head Neck Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  413-9     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Laval University, Quebec, QC.
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MeSH Terms
Descriptor/Qualifier:
Cleft Lip / complications*,  surgery
Cleft Palate / complications*,  surgery
Hospitals, University
Humans
Infant
Infant, Newborn
Intubation, Intratracheal / contraindications*
Laryngoscopy / contraindications
Length of Stay
Pierre Robin Syndrome / complications*
Retrospective Studies
Risk

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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