Intensive Care Unit Monitoring After Pharyngeal Flap Surgery: Is it necessary?

Publication date: Available online 1 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sashank Reddy, Srinivas Susarla, Nance Yuan, Gurjot Walia, Danielle Rochlin, Richard Redett
PurposeTo assess the incidence of perioperative complications and the utility of intensive care monitoring in patients undergoing posterior pharyngeal flap surgery for velopharyngeal dysfunction (VPD).MethodsWe performed a retrospective evaluation of patients who underwent posterior pharyngeal flap surgery for treatment of VPD and assessed the incidence of perioperative complications. Descriptive statistics were computed.ResultsOver an 18-year period, 145 subjects underwent pharyngeal flap surgery for VPD; 133 (91.7%) had complete data and were included as subjects. The mean patient age was 9.4 + 7.4 years; 50.4% were female. One-hundred twenty-six subjects (94.7%) had a history of cleft palate. Thirty-four subjects (25.5%) had asthma or obstructive sleep apnea. Eighty-three subjects (62.4%) were admitted to the ICU for postoperative monitoring. The average length of hospital stay was 1.9 + 0.9 days (range: 1-5 days). There were no incidents of serious postoperative complications including death, bleeding, flap dehiscence/loss, or airway compromise requiring re-intubation. Two subjects (1.5%) had perioperative complications related to respiratory issues, one of whom required re-admission to the ICU (0.8%). There were no differences in complications between those who were routinely admitted to the ICU and those who went directly to the floor (p = 1.00). There was no association between respiratory comorbidities and complications (p = 0.06).ConclusionThe perioperative complication rate for posterior pharyngeal flap surgery is low (<2%). Routine ICU admission for monitoring is not necessary.



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