Alyssa Brzenski. Overview Basic statistics of Cleft Lips and Cleft Palate Basic embryology of Cleft...
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Alyssa Brzenski. Overview Basic statistics of Cleft Lips and Cleft Palate Basic embryology of Cleft Lips and Palates Common Associated Syndromes Anesthetic
Overview Basic statistics of Cleft Lips and Cleft Palate Basic
embryology of Cleft Lips and Palates Common Associated Syndromes
Anesthetic Implications Common complications
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Cleft Lip/Palate Statistics Merrit L. Understanding the
Embryology and Genetics of Cleft Lip and Palate. Advances in
Neonatal Care 2005; 5: 64-71.
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Risk Factors Merrit L. Understanding the Embryology and
Genetics of Cleft Lip and Palate. Advances in Neonatal Care 2005;
5: 64-71.
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Embryology Merrit L. Understanding the Embryology and Genetics
of Cleft Lip and Palate. Advances in Neonatal Care 2005; 5:
64-71.
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Facial Development
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Cleft Lip Embryology
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Cleft Palate
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Non-syndromic Orofascial Clefts Mossey et al. Cleft Lip and
Palate. Lancet 2009; 374: 1773-85.
Should I expect a difficult intubation? 7% of children for
Cleft lip or Cleft palate Retrognathia Age less than 6 months
Bilateral cleft Wide Cleft No difficulty ventilating
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Anesthesia Mask Induction PIVx1 Intubate and place an oral rae
Balanced anesthetic Post-op Pain control with long-acting narcotic
Infraorbital Nerve blocks for cle Awake on extubation to protect
airway May have tounge stich Avoid oral airways
Causes of Upper Airway obstruction Edema of the tongue from the
Dingman retractor Reduction in the size of the oropharynx Excessive
sedation
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Post-operative Palate Fistula Causes Type of cleft Wound
tension Type of repair Single layer repair Infection Age of patient
at time of repair
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Future Procedures Ear Tubes Palatoplasty- for velopharyngeal
insufficiency Alveolar Bone Graft (8-10 years of age) Extensive
orthodontic care Speech Therapy
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Questions?
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Sources Merrit L. Understanding the Embryology and Genetics of
Cleft Lip and Palate. Advances in Neonatal Care 2005; 5: 64-71.
Arteau-Gauthier I, Leclerc JE, Godbout A. Can we predict a
difficult intubation in cleft lip/palate patients? J Otolaryngol
Head Neck Surg. 2011; 40:413-9. Mossey PA, Little J, Munger RG,
Dixon MJ, Shaw WC. Cleft lip and Palate. The Lancet. 2009; 374:
1773-85. Loose JE, et al. A Successful Algorithm for Limiting
Postoperative Fistulae following Palatal Procedures in the Patient
with Orofacial Clefting. Plastic and Reconstructive Surgery. 2008;
122: 544-54. Shan Phua Y, Chalain T.Incidence of Oronasal Fistulae
and Velopharyngeal Insufficiency After Cleft Palate Repair: An
Audit of 211 Children Born Between 1990 and 2004. Cleft
Palate-Craniofacial Journal. 2008; 45: 172-8. Cote, Lerman, Todres.
A Practice of Anesthesia for Infants and Children. 2009. 4 th Ed.
Tremlett M. Anaesthesia for Cleft Lip and Palate Surgery. Current
Anaesthesia and Critical Care. 2004; 15: 309-16.