Moraleda-Cibrián Marta, Berger Mary, Edwards Sean P, Kasten Steven J, Buchman Steven R, O'Brien Louise M
Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI ; Department of Oral & Maxillofacial Surgery, University of Michigan, Ann Arbor, MI.
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI.
J Clin Sleep Med. 2014 Jun 15;10(6):671-6. doi: 10.5664/jcsm.3798.
Sleep-disordered breathing (SDB) and speech difficulties are common problems in children with craniofacial malformations (CFM). The present study was designed to investigate whether resonance issues identified during speech assessment are associated with parental report of SDB symptoms in children with CFM.
Children aged 2-18 years with congenital CFM attending at the Craniofacial Anomalies Program from March 2007 to April 2011 were screened for SDB symptoms using the Sleep-Related Breathing Disturbance Scale of the Pediatric Sleep Questionnaire. Speech evaluation, based on the Pittsburgh Weighted Speech Scale score, was the tool used to investigate velopharyngeal dysfunction (VPD) based on speech perceptual assessment.
A total of 488 children with congenital CFM were included. Overall 81% were Caucasian and 24% were overweight/obese. Twenty-four percent of children screened positive for SDB and 35% had VPD. Children with VPD were no more likely to screen positive for SDB than children without VPD (26% vs. 23%, p = 0.38). However, children with previous sphincter pharyngoplasty (SP) were more likely to have hyponasality (51% vs. 12%, p = 0.0001) and reduced or absent nasal emission (33% vs. 16%, p = 0.008). In a logistic regression, the adjusted odds ratio for SDB for those with hyponasality was 2.10 (95%CI 1.21-3.61, p = 0.008) and for those with reduced or absent nasal emission was 1.75 (95%CI 1.06-2.88, p = 0.028).
Symptoms of sleep disordered breathing are common in children with craniofacial malformations especially if they have undergone sphincter pharyngoplasty; many of these children can be identified by measures of resonance on routine speech evaluation.
睡眠呼吸障碍（SDB）和言语困难是颅面畸形（CFM）儿童的常见问题。本研究旨在调查言语评估中发现的共鸣问题是否与CFM儿童家长报告的SDB症状相关。
对2007年3月至2011年4月在颅面畸形项目就诊的2至18岁先天性CFM儿童，使用儿童睡眠问卷的睡眠相关呼吸障碍量表筛查SDB症状。基于匹兹堡加权言语量表评分的言语评估是用于基于言语感知评估调查腭咽功能障碍（VPD）的工具。
共纳入488例先天性CFM儿童。总体而言，81%为白种人，24%超重/肥胖。24%的儿童SDB筛查呈阳性，35%有VPD。有VPD的儿童SDB筛查呈阳性的可能性并不比没有VPD的儿童更高（26%对23%，p = 0.38）。然而，既往接受过括约肌咽成形术（SP）的儿童更易出现鼻音减退（51%对12%，p = 0.0001）和鼻气流减少或消失（33%对16%，p = 0.008）。在逻辑回归分析中，鼻音减退者SDB的校正比值比为2.10（95%CI 1.21 - 3.61，p = 0.008），鼻气流减少或消失者为1.75（95%CI 1.06 - 2.88，p = 0.028）。
睡眠呼吸障碍症状在颅面畸形儿童中很常见，尤其是那些接受过括约肌咽成形术的儿童；通过常规言语评估中的共鸣测量可以识别出许多此类儿童。
