Influence of patient age and experience of the surgeon on early complications after surgical closure of the cleft palate--a retrospective cohort study

J Craniomaxillofac Surg. 2013 Mar;41(2):135-9. doi: 10.1016/j.jcms.2012.06.005. Epub 2012 Jul 27.

Abstract

Comparative studies on timing of palatoplasty are rare. The aim of this retrospective cohort study was to compare the influence of early (<14 months) and later (>14 months) one-step closure of the soft and hard palate on early complications. All non-syndromic patients from 1999 to 2009 were included; 6-14 months n = 41 and 15-24 months n = 53. Each palatoplasty was performed as a single-step procedure using bipedicled flaps by a team of two Maxillofacial Surgeons either supervising or operating. The surgeon was rated as "non-experienced" when having performed less than 10 palatoplasties under supervision. Main outcome variable is the occurrence of residual fistula. Fistula occurred in four (4.5%) of the patients. In the multivariate model with respect to the occurrence of fistula neither age, leucocyte count, duration of surgery, nor experience of the surgeon showed a significant influence on the occurrence of a fistula. Only reduced weight contributed to a significantly higher risk of post-operative fistula. In conclusion patient age, experience of surgeon, and duration of surgery had no influence on the early outcome. High leucocyte count had a tendency for and reduced weight had a significant influence on fistula occurrence. Long-term outcome on speech development and maxillary growth have to be collected.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Analgesics / therapeutic use
  • Body Weight
  • Child, Preschool
  • Cleft Palate / surgery*
  • Clinical Competence*
  • Cohort Studies
  • Follow-Up Studies
  • Humans
  • Infant
  • Leukocyte Count
  • Operative Time
  • Oral Fistula / etiology
  • Palate, Hard / surgery
  • Palate, Soft / surgery
  • Postoperative Complications*
  • Retrospective Studies
  • Surgical Flaps
  • Treatment Outcome

Substances

  • Analgesics