Sleep‐Related Obstructive Disordered Breathing in Cleft Palate Patients after Palatoplasty

  title={Sleep‐Related Obstructive Disordered Breathing in Cleft Palate Patients after Palatoplasty},
  author={Edmund Clemens Rose and Richard Staats and Ulrike Thissen and J{\"o}rg-Eland Otten and Rainer Schmelzeisen and Irmtrud E. Jonas},
  journal={Plastic and Reconstructive Surgery},
&NA; Sleep‐disordered breathing is frequently associated with children presenting congenital midface defects. Because of structural and functional anomalies in the upper airway, children with cleft palate, especially after surgery, may carry a higher risk of developing sleep‐disordered breathing. However, the presence of such sleep‐disordered breathing in older cleft palate children has not been emphasized. The aim of this comparative overnight cardiorespiratory sleep study was to evaluate… 

Impact of Syndromes on Sleep-Disordered Breathing in Children After Cleft Palate Repair.

It was showed that children with CP experience higher rates of SDB after palatoplasty than the general pediatric population and Clinicians should counsel caregivers accordingly and closely monitor these groups for SDB for palate repair.

Cephalometric Assessment of the Posterior Airway Space in Patients with Cleft Palate after Palatoplasty

Patients with cleft palate appear to present pharyngeal and craniofacial distinctive features that characterize patients with obstructive sleep disordered breathing and differ from those of a noncleft control.

Cephalometric assessment of the posterior airway space in patients with cleft palate after palatoplasty.

  • E. RoseU. ThissenJ. OttenI. Jonas
  • Medicine
    The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
  • 2003
Patients with cleft palate appear to present pharyngeal and craniofacial distinctive features that characterize patients with obstructive sleep disordered breathing and differ from those of a noncleft control.

Respiratory Polysomnographic Findings in Patients Treated Primarily for Unilateral Cleft Lip and Palate

This sample of patients with unilateral cleft lip and palate exhibited an increased prevalence of OSAS during the mixed dentition stage, and the results showed that OSAS was mild, it is advised to advise closer observation of these patients.

Effect of cleft palate repair with vomer flap on incidence and severity of obstructive sleep apnea

Utilization of a vomer flap during cleft palate repair did not have a statistically significant effect on the presence or severity of OSAS.

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

Preschool children with cleft lip and/or palate have a risk of obstructive sleep apnea that is as much as five times that of children without cleft.

Surgical Closure of the Cleft Palate Has a Transient Obstructive Effect on the Upper Airway in Children

The results support the conclusion that OSA is underappreciated in this population of children with cleft palate, and indicate that children with a palatal cleft who undergo surgical repair are at risk for OSA.

Will Obstructive Sleep Apnea and Apnea/Hypopnea Index Be Corrected Following Alveolar Cleft Reconstruction?

It was showed that the OSA and AHI ameliorated after bone graft surgery in alveolar cleft repair and reconstruction, and more clinical trials including larger sample sizes may be required for relevancy.

Comparison of Clinical Symptoms and Severity of Sleep Disordered Breathing in Children with and without Cleft Lip and/or Palate

Snoring and obstructive sleep apnea are common in CL/P with less tonsillar enlargement than non-CL/P children but more central apnea which may indicate differences in the control of breathing.

Snoring in cleft patients with velopharyngoplasty.




Effect of cleft palate repair and pharyngeal flap surgery on upper airway obstruction during sleep.

The data suggest that palatoplasty carries with it a very slight risk of upper airway obstruction, whereas pharyngeal flap surgery has as a very frequent concomitant the occurrence of severe obstructive sleep apnea in the immediate postoperative period.

Sleep Apnea Following a Pharyngeal Flap: A Feared Complication

The data show that significant sleep apneas following pharyngeal flaps may not be as frequent or permanent as previously reported, and independent analysis of arterial oxygen saturation revealed that the percentage of time with a saturation of less than 90 percent identifies patients with clinically significant apnea.

Robin sequence: obstructive sleep apnea following pharyngeal flap.

Alternative management should be considered: modification of the standard pharyngeal flap, palatal lengthening (V-Y or double-opposing Z-plasty), or construction of a speech bulb.

[Obstructive sleep apnea in the child: an interdisciplinary treatment concept with special reference to craniofacial changes].

Adenotonsillectomy is highly effective in infants and does not only reduce SRBD, but also improves nasal breathing and thus positively influences facial growth, and a relatively new method is gradual mandibular distraction osteogenesis according to Ilizarov, which also enhances soft tissue growth.

Obstructive sleep apnea secondary to surgery for velopharyngeal insufficiency.

Preoperative assessment of tonsillar tissue is of vital importance before pharyngeal flap surgery, and sizeable tonsils were found in 13 out of 15 cases, whereas flap width appeared unrelated to obstruction.

Obstructive sleep apnea in Treacher-Collins syndrome.

An eight-year-old with Treacher-Collins syndrome presented a history of recent behavioral problems at home, poor attention span and performance in school, daytime somnolence, and sleep apnea with relatively long periods of chest movement but no airflow, and underwent orthognathic surgery, which resulted in disappearance of the obstructiveSleep apnea and associated symptoms.

Treatment of obstructive sleep apnea syndrome in children.

Nasal mask continuous positive airway pressure (CPAP) is an effective non-invasive treatment that prevents the majority of obstructive events, reverses sleep disturbances, improves daytime performance and is associated with increased growth in patients with failure to thrive.

Relief of Upper Airway Obstruction by Adenotonsillectomy

It appears that surgery in such cases can have far-ranging benefits, even for the child whose obstruction does not demonstrate severe apnea, as demonstrated by parental questionnaire and sleep sonography—the computer-aided analysis of respiratory sounds.