Cleft lip and palate are the most common craniofacial deformities in the United States of America and México. Their aesthetic and functional implications influence the lifestyle of the patient: social relationships, school and working performances, self-esteem and health. Surgical repair of the cleft lip is around the third to sixth month of age and the palate repair is when the patient is between six and eighteen months old. There are other surgical repairs during childhood and ideally all of them should be performed by an experienced surgeon teaming up with a pediatric anesthesiologist following the gold standards in cleft care, in a setting where the safety of the patient is paramount.
Part of the book: Anesthesia Topics for Plastic and Reconstructive Surgery
There is a high risk of adverse events during anesthetic management in the pediatric population mainly in children under 1 year of age and with greater vulnerability: those undergoing head and neck surgery for involving airway, specifically patients who enter surgical correction of the lip and cleft palate. This pathology can be related in a high percentage to isolated malformations without integrating a specific syndrome or be part of the more than 500 associated craniofacial syndromes such as sequence Pierre Robin, Treacher Collins, and Goldenhar, among others; it is also associated in up to 10% with some heart disease. Factors that are determinants for anesthetic management have been identified in corrective surgery of the lip and cleft palate related to the patient’s characteristics such as age and weight, his medical history or associated comorbidities, and the surgical technique. As it is the pathology with the highest incidence in facial malformations that requires surgical treatment, it is necessary to know the anesthetic management alternatives and establish criteria in the different stages of the perioperative period from preanesthetic assessment to postanesthetic care, in order to provide planned approach within the highest safety standards that reduce the risk of adverse events.
Part of the book: Current Treatment of Cleft Lip and Palate