Liao Yu-Fang, Noordhoff M Samuel, Huang Chiung-Shing, Chen Philip K T, Chen Ning-Hung, Yun Claudia, Chuang Ming-Lung
Division of Orthodontics, the Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
Cleft Palate Craniofac J. 2004 Mar;41(2):152-6. doi: 10.1597/02-162.
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).
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.
An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively.
Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured.
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).
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.
评估采用Furlow腭成形术或咽瓣修复腭裂患者腭咽闭合不全(VPI)后阻塞性睡眠呼吸暂停综合征(OSAS)的发生率和严重程度。
本研究共纳入48例非综合征性腭裂修复术后合并VPI的儿童。其中20例儿童接受Furlow腭成形术(F组),28例儿童接受咽瓣修复术(P组)以纠正VPI。
术后6个月或更长时间进行整夜多导睡眠图评估,以评估OSAS的发生率和严重程度。
测量OSAS症状、呼吸紊乱指数(RDI)、氧合血红蛋白去饱和指数(DI)和睡眠阶段。
P组2期睡眠的平均百分比低于F组(p<.05)。与F组相比,P组的平均RDI和DI更大(p<.001)。与F组相比,P组OSAS的发生率和严重程度更高(分别为p<.001和p = 0.05)。
基于术前对VPI的评估,由于OSAS的发生率和严重程度降低,应尽可能优先于咽瓣使用Furlow腭成形术。