Cleft Lip and/or Palate Repair in Children With Hypopituitarism: Analysis of the Kids' Inpatient Database

Cleft Palate Craniofac J. 2024 Jan;61(1):94-102. doi: 10.1177/10556656221117435. Epub 2022 Jul 29.


Objective: Children with hypopituitarism (CwHP) can present with orofacial clefting, frequently in the setting of multiple midline anomalies. Hypopituitarism (HP) can complicate medical and surgical care; the perioperative risk in CwHP during the traditionally lower risk cleft lip and/or palate (CL/P) repair is not well described. The objective of this study is to examine the differences in complications and mortality of CL/P repair in CwHP compared to children without hypopituitarism (CwoHP).

Design: A retrospective cross-sectional analysis.

Setting: The 1997 to 2019 Kids' Inpatient Databases (KID).

Patients: Children 3 years old and younger who underwent CL/P repair.

Main outcome measure(s): Complications and mortality.

Results: A total of 34 106 weighted cases were analyzed, with 86 having HP. CwHP had a longer length of stay (3.0 days [IQR 2.0-10.0] vs 1.0 day [IQR 1.0-2.0], P < .001) and higher rates of complications and mortality (12.8% vs 2.9%, P < .001) compared to CwoHP. Controlling for demographic factors, CwHP had 6.61 higher odds of complications and mortality than CwoHP (95% CI 3.38-12.94, P < .001).

Conclusions: CwHP can present with a CL/P and other midline defects that can increase the complexity of their care. These data show a significant increase in length of stay, complications, and mortality in CwHP undergoing CL/P repair. Increased multidisciplinary attention and monitoring may be needed for these children peri- and postoperatively, especially if additional comorbidities are present. Further studies on perioperative management in this population are warranted to reduce morbidity and mortality.

Keywords: etiology; palatoplasty; pediatrics; surgical complications.

MeSH terms

  • Child
  • Child, Preschool
  • Cleft Lip* / surgery
  • Cleft Palate* / surgery
  • Cross-Sectional Studies
  • Humans
  • Infant
  • Inpatients
  • Postoperative Complications / epidemiology
  • Retrospective Studies