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

Abstract

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.