Due to the timing of oral cleft surgeries, typically performed at an extremely young age, children with an oral cleft were believed to experience cognitive dysfunction and academic underachievement later in life due to early exposure to general anesthesia. Yet new research from the University of Southern Denmark and the University of Iowa suggests that poor results on academic exams of those born with oral clefts are not related to this early exposure.
Because the definite age of maximum vulnerability to general anesthesia is unknown and widely debated, the effect of oral cleft surgery at an early age on academic achievement among adolescents is unclear. The researchers suspected that any potential neurotoxic effect caused by extensive exposure to anesthesia at an early age would show up in poor test results in ninth-grade final exams.
The researchers based their study on 558 adolescents from a nationwide Danish registry who had undergone surgery for cleft lip, cleft palate, or both while young. The researchers found that 509 of the oral cleft children had been exposed to anesthesia and had undergone at least one cleft operation. Then, the researchers compared the level of academic achievement of the students in the registry against that of a control group.
Despite the early and frequent exposure to anesthesia, children with a cleft lip, cleft palate, or both showed no significant difference in their ninth-grade test scores than those of the students in the control group. However, students with only a cleft palate did have lower test scores than the students in the control group. Children with a cleft palate only are generally older when surgery is performed than children with other types of clefts.
“This finding is remarkable,” said researcher Nicola Clausen, MD, PhD, of the Department of Anesthesia and Intensive Care at University Hospital Odense in Denmark. “Studies like the present one cannot definitely prove that anesthetic drugs do not harm developing brains. However, it can put the potential threats into perspective because other factors more importantly impact these children’s neurocognitive development.”
The researchers concluded that oral cleft type, rather than the timing of anesthesia or number of cleft operations, is linked to poorer academic performance. Although the researchers saw no evidence in their study to suggest surgeons need to change their anesthetic methods, a neurotoxic effect due to anesthetics cannot be completely dismissed, they said.
The study, “Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts,” was published by the Cleft Palate-Craniofacial Journal.