Robin Sequence: Obstructive Sleep Apnea following Pharyngeal Flap

1997 ◽  
Vol 34 (3) ◽  
pp. 256-260 ◽  
Author(s):  
David L. Abramson ◽  
Eileen M. Marrinan ◽  
John B. Mulliken
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Robin Sequence ◽  
Obstructive Sleep ◽  
High Incidence ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Pharyngeal Flap ◽  
Velopharyngeal Function ◽  
Repair Group

Objective We reviewed 24 children with Robin sequence who underwent cleft palate repair. Method All patients were 5 years of age or older at the time of review, allowing for accurate assessment of speech in relation to velopharyngeal function. All infants had palatal closure between 9 and 14 months of age, either V-Y repair (n = 16) or von Langenbeck repair (n = 8). Results Only 1 of 16 children who had V-Y repair had borderline velopharyngeal dysfunction (VPD). For reasons that are unclear, in the von Langenbeck repair group, six of eight children had VPD, and four of six underwent pharyngeal flap. Three additional patients with nonsyndromic Robin sequence had palatoplasty and subsequent pharyngeal flap. Six of the combined total of seven children with nonsyndromic Robin sequence developed obstructive sleep apnea and required flap take-down. Conclusion Since conventional pharyngeal flap for VPD in nonsyndromic Robin sequence children resulted in a high incidence of obstructive sleep apnea, 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.

An Oral Appliance with Velar Extension for Treatment of Obstructive Sleep Apnea in Infants with Pierre Robin Sequence

2011 ◽  
Vol 48 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Margit Bacher ◽  
Judit Sautermeister ◽  
Michael S. Urschitz ◽  
Wolfgang Buchenau ◽  
Joerg Arand ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oral Appliance ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Obstructive Sleep ◽  
Pierre Robin

Incidence and Severity of Obstructive Sleep Apnea following Pharyngeal Flap Surgery in Patients with Cleft Palate

2002 ◽  
Vol 39 (3) ◽  
pp. 312-316 ◽  
Author(s):  
Yu-Fang Liao ◽  
Ming-Lung Chuang ◽  
Philip K.T. Chen ◽  
Ning-Hung Chen ◽  
Claudia Yun ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Flap Surgery ◽  
Adult Group ◽  
Child Group ◽  
Obstructive Sleep ◽  
Pharyngeal Flap ◽  
Respiratory Disturbance ◽  
Different Levels

Objective: To investigate the incidence and severity of obstructive sleep apnea (OSA) associated with pharyngeal flap surgery in patients with cleft palate at least 6 months postoperatively and to determine whether age or the flap width had an effect on them. The hypothesis tested in this study was that the severity of OSA associated with pharyngeal flap surgery is greater in children than in adults. Subjects: Ten adults, six men and four women, with a mean age of 28.0 years at pharyngeal flap (adult group). Twenty-eight children, 13 boys and 15 girls, with a mean age of 6.3 years at pharyngeal flap (child group). Design: A prospective analysis. Main Outcome Measures: An overnight polysomnographic study was used to determine the incidence and severity of OSA 6 months after pharyngeal flap. Results: The incidence of OSA following pharyngeal flap was high but not significantly different between these two groups (90% in adults and 93% in children, p = 1.000). When OSA was stratified into different levels of severity according to the values of respiratory disturbance index, there were noticeable differences between these two groups (p = .022). In the adult group, eight patients (89%) had mild OSA and 1 patient (11%) had moderate to severe OSA. In the child group, 11 patients (42%) were found to have mild OSA, and 15 patients (58%) had moderate to severe OSA. No relation was found between the flap width and the incidence (p = .435 in adults and .640 in children) or the severity (p = .325 in adults and .310 in children) of OSA in each group. Conclusions: Six months following pharyngeal flap surgery, more than 90% of the patients with cleft palate still had OSA. The severity of OSA associated with pharyngeal flap surgery tended to be greater in children than in adults. The flap width was unrelated to the incidence and severity of OSA, no matter in adults or in children.

Defining Risk of Postoperative Obstructive Sleep Apnea in Patients With 22q11.2DS Undergoing Pharyngeal Flap Surgery for Velopharyngeal Dysfunction Using Polysomnographic Evaluation

2020 ◽  
Vol 57 (7) ◽  
pp. 808-818
Author(s):  
Alfred Lee ◽  
Brian L. Chang ◽  
Cynthia Solot ◽  
Terrence B. Crowley ◽  
Vamsee Vemulapalli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
Apnea Hypopnea Index ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Pharyngeal Flap

Objective: To determine pre- and postoperative prevalence of obstructive sleep apnea (OSA) in patients with 22q11.2 deletion syndrome (DS) undergoing wide posterior pharyngeal flap (PPF) surgery for velopharyngeal dysfunction (VPD). Design: Retrospective study using pre- and postoperative polysomnography (PSG) to determine prevalence of OSA. Medical records were reviewed for patients’ medical comorbidities. Parents were surveyed about snoring. Setting: Academic tertiary care pediatric hospital. Patients: Forty patients with laboratory confirmed 22q11.2DS followed over a 6-year period. Interventions: Pre- and postoperative PSG, speech evaluation, and parent surveys. Main Outcome Measure: Severity and prevalence of OSA, defined by obstructive apnea hypopnea index (OAHI), before and after PPF surgery to determine whether PPF is associated with increased risk of OSA. Results: Mean OAHI did not change significantly after PPF surgery (1.1/h vs 2.1/h, P = .330). Prevalence of clinically significant OSA (OAHI ≥ 5) was identical pre- and postoperatively (2 of 40), with both cases having severe-range OSA requiring positive airway pressure therapy. All other patients had mild-range OSA. Nasal resonance was graded as severe preoperatively in 85% of patients. None were graded as severe postoperatively. No single patient factor or parent-reported concern predicted risk of OSA (OAHI ≥ 1.5). Conclusions: Patients with 22q11.2DS are medically complex and are at increased risk of OSA at baseline. Wide PPF surgery for severe VPD does not significantly increase risk of OSA. Careful perioperative planning is essential to optimize both speech and sleep outcomes.

Adenoid hypertrophy causing obstructive sleep apnea in children after pharyngeal flap surgery

2019 ◽  
Vol 276 (12) ◽  
pp. 3413-3417 ◽  
Author(s):  
Mosaad Abdel-Aziz ◽  
Mahmoud El-Fouly ◽  
Essam A. A. Elmagd ◽  
Ahmed Nassar ◽  
Assem Abdel-Wahid
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Adenoid Hypertrophy ◽  
Flap Surgery ◽  
Obstructive Sleep ◽  
Pharyngeal Flap

Prevalence and Severity of Obstructive Sleep Apnea and Snoring in Infants with Pierre Robin Sequence

2011 ◽  
Vol 48 (5) ◽  
pp. 614-618 ◽  
Author(s):  
Iee Ching W. Anderson ◽  
Ahmad R. Sedaghat ◽  
Brian M. McGinley ◽  
Richard J. Redett ◽  
Emily F. Boss ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Obstructive Sleep ◽  
Pierre Robin

Comparison of Obstructive Sleep Apnea Syndrome in Children with Cleft Palate following Furlow Palatoplasty or Pharyngeal Flap for Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Yu-Fang Liao ◽  
M. Samuel Noordhoff ◽  
Chiung-Shing Huang ◽  
Philip K. T. Chen ◽  
Ning-Hung Chen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pharyngeal Flap ◽  
Apnea Syndrome

Objective To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI). Patients A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI. Interventions An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively. Main Outcome Measures Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured. Results In the P group, the mean percentage of stage 2 sleep was lower than the F group (p < .05). The mean RDI and DI were larger in the P group, compared with the F group (p < .001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p < .001 and p = 0.05, respectively). Conclusions A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.

scholarly journals ДІАГНОСТИКА СИНДРОМУ ОБСТРУКТИВНОГО АПНОЕ / ГІПОПНОЄ В АМБУЛАТОРНІЙ ПРАКТИЦІ

World Science ◽  
2019 ◽  
Vol 2 (1(41)) ◽  
pp. 11-14
Author(s):  
Івчина Н. А.
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Common Disease ◽  
Upper Respiratory Tract ◽  
Blood Oxygen Saturation ◽  
Obstructive Sleep ◽  
The Family ◽  
High Incidence ◽  
Upper Respiratory ◽  
Hypopnea Syndrome

The syndrome of obstructive sleep apnea/hypopnea is a common disease which is caused by obstruction of the upper respiratory tract. This condition is characterized by repeated pauses in breathing during sleep. It is usually associated with a decrease in blood oxygen saturation. Primary risk factors of obstructive sleep apnea/hypopnoea syndrome — age, being a male and the family anamnesis. To the minor factors contributing to development of obstructive sleep apnea/hypopnoea syndrome, adiposity, abusing alcohol, the smoking, a habitual snore, day drowsiness.The researchers are interested in this problem due to the fact that obstructive sleep apnea/hypopnea syndrome is an adverse consequence of cardiovascular diseases and sudden death. Objective. Determine the prevalence of this disease in the outpatient medical practiceMaterial and methods. Out-patient cardio-respiratory monitoring. Results and discussion. High incidence of disease in outpatient patients.

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