4.5 Article

Malnutrition as a Risk Factor in Cleft Lip and Palate Surgery

Journal

LARYNGOSCOPE
Volume 131, Issue 6, Pages E2060-E2065

Publisher

WILEY
DOI: 10.1002/lary.29209

Keywords

Cleft lip and palate; fistula; dehiscence; malnutrition

Funding

  1. Children's Minnesota Internal Research Grant Program

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This study assessed the prevalence of acute and chronic malnutrition in patients with cleft lip and/or palate at the time of surgery, and found that improved nutritional status, as measured by height-for-age, can decrease the risk of fistula formation after cleft palate surgery.
Objectives/Hypothesis To assess the prevalence of acute and chronic malnutrition at the time of surgery in patients with cleft lip and/or palate (CLP) at our institution, and to quantify nutrition as a risk factor for postsurgical complications following CLP surgery. Study Design Retrospective cohort study. Methods Retrospective review of 855 children undergoing initial cleft lip or palate surgery, or revision surgery after fistula/dehiscence of initial cleft repair. We measured acute and chronic malnutrition using World Health Organization Z-scores of weight-for-age and height-for-age, respectively, and noted any postsurgical fistula or dehiscence. Results Among patients with cleft lip, 22.3% were at least moderately chronically malnourished at the time of initial repair, and 17.5% were at least moderately acutely malnourished. Among patients undergoing initial repair of cleft palate, 20.9% were at least moderately chronically malnourished, and 8.1% were at least moderately acutely malnourished. Increasing nutritional status, as measured by height-for-age, predicts decreased odds of fistula (OR 0.78, P = .01) after cleft palate surgery. Conclusions Chronic malnutrition significantly increases the risk of fistula formation in patient with cleft palate. Preoperative strategies to manage this risk and influence surgical timing can avoid morbid and costly postoperative complications. Level of Evidence 4 Laryngoscope, 2020

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