title: Utility of Tongue Stitch and Nasal Trumpet in the Immediate Postoperative Outcome of Cleft Palatoplasty.
abstract: BACKGROUND
  Postoperative airway obstruction is a feared complication following cleft palate repair. The aim of this study was to evaluate the effectiveness of tongue stitches and nasal trumpets that have been used in an attempt to prevent this complication.
  
  
  METHODS
  An 8-year (2005 to 2013) retrospective review of palatoplasties performed at a tertiary care center was conducted. Patients were divided into three groups: those with no airway protective measure, those with a tongue stitch only, and a group with nasal trumpet and tongue stitch. Recorded variables included sex, age, Veau classification, and comorbidities. Primary outcomes measured were postoperative respiratory distress, readmission, and reoperation rates.
  
  
  RESULTS
  Fifty-eight patients underwent palatoplasties with no airway protective measure, 252 patients had tongue stitch only, and 87 had tongue stitch and nasal trumpet. There were no significant differences between groups with respect to comorbidities except that cleft lip was more prevalent in the no-airway protection group than in the other two groups (p = 0.04). There was no significant difference in the incidence of reintubation, intensive care unit transfer, surgery-related readmissions, or reoperation. Respiratory complications were significantly increased in the nasal trumpet group even after adjusting for age and weight. Length of stay was also significantly (p < 0.01) shortened when comparing no airway protection to those who underwent both nasal trumpet and tongue suture placement.
  
  
  CONCLUSIONS
  The use of a tongue stitch, with or without nasal trumpet, did not correlate with improved safety and outcomes. Patients without these airway protective measures had a shorter hospital stay.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Indianapolis, Ind.; and New York, N.Y. From Indiana University and New York University.
authors.forename: Sidhbh
authors.initials: S
authors.lastname: Gallagher
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrera
authors.forename: Leigh
authors.initials: L
authors.lastname: Spera
authors.forename: Barry L
authors.initials: BL
authors.lastname: Eppley
authors.forename: Tahereh
authors.initials: T
authors.lastname: Soleimani
authors.forename: Youssef
authors.initials: Y
authors.lastname: Tahiri
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sood
authors.forename: Roberto L
authors.initials: RL
authors.lastname: Flores
authors.forename: William A
authors.initials: WA
authors.lastname: Wooden
authors.forename: Sunil S
authors.initials: SS
authors.lastname: Tholpady
mesh_terms: D000402:Airway Obstruction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D009296:Nasal Cavity; D011183:Postoperative Complications; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures / Q000706:statistics & numerical data*; D014059:Tongue / Q000601:surgery*; D014481:United States / Q000453:epidemiology
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