title: Influence of patient age and experience of the surgeon on early complications after surgical closure of the cleft palate--a retrospective cohort study.
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.
authors: Oral-, Maxillofacial- and Plastic Surgery, University Medical Hospital of the J. Gutenberg UniversityMainz, Germany. bilal.al-nawas@unimedizin-mainz.de
authors: Bilal
authors: B
authors: Al-Nawas
authors: Susanne
authors: S
authors: Wriedt
authors: Jennifer
authors: J
authors: Reinhard
authors: Annerose
authors: A
authors: Keilmann
authors: Heiner
authors: H
authors: Wehrbein
authors: Wilfried
authors: W
authors: Wagner
mesh_terms: D000367:Age Factors; D000700:Analgesics / Q000627:therapeutic use; D001835:Body Weight; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D002983:Clinical Competence; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D061646:Operative Time; D016155:Oral Fistula / Q000209:etiology; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D000700:Analgesics