Increased prevalence of obstructive sleep apnea in patients with cleft palate
Department of Pediatric Otolaryngology, Children’s Hospital of Pittsburgh, 4401 Penn Ave, Floor 3, Pittsburgh, PA 15224, USA.
To evaluate the prevalence of sleep-disordered breathing (SDB) and/or obstructive sleep apnea (OSA) in the population with nonsyndromic cleft palate.
Retrospective medical record review of symptoms of SDB and/or OSA and results of polysomnography (PSG) studies.
The craniofacial clinic of a tertiary pediatric hospital.
A total of 459 patients, with an additional 48 patients with Pierre Robin syndrome, met inclusion criteria.
MAIN OUTCOME MEASURES:
Medical records from January 1, 2005, through July 31, 2009, were reviewed for demographic data, SDB symptoms, surgical procedures, and PSG results.
Of the 459 patients, 172 (37.5%) had symptoms of SDB and 39 (8.5%) had PSG-diagnosed OSA. Forty-six patients underwent 1 or more PSGs, with results of 49 of the 59 studies (83.1%) being positive for OSA. Surgical procedures to address SDB and/or OSA were undertaken in 89 patients (51.7%), with combined tonsillectomy and adenoidectomy the most common procedure (44.9%). An additional 48 patients who met the inclusion criteria with a diagnosis of Pierre Robin syndrome were also identified. In this population, 35 patients (72.9%) had symptoms of SDB and/or OSA.
An increased prevalence of SDB and/or OSA exists in the population with cleft palate, with an even greater prevalence in patients with Pierre Robin syndrome. Definitive diagnosis of OSA by PSG is underused. We suggest that surgical management of SDB and/or OSA be followed by PSG to demonstrate resolution or persistence of symptoms to ensure appropriate further management.
Arch Otolaryngol Head Neck Surg. 2011 Mar;137(3):269-74.