Campos Letícia Dominguez, Trindade-Suedam Ivy Kiemle, Sampaio-Teixeira Ana Claudia Martins, Yamashita Renata Paciello, Lauris José Roberto Pereira, Lorenzi-Filho Geraldo, Trindade Inge Elly Kiemle
Cleft Palate Craniofac J. 2016 May;53(3):e53-9. doi: 10.1597/14-152. Epub 2015 Mar 20.
To compare the frequency and severity of obstructive sleep apnea (OSA) in middle-aged adults who underwent pharyngeal flap surgery for velopharyngeal insufficiency (VPI) with matched subjects who did not undergo pharyngeal flap surgery and to verify the relationship between OSA severity and internal pharyngeal dimensions.
National referral care center for cleft lip and palate.
Prospective study on 42 nonsyndromic subjects with repaired cleft palate with flap (F group, n = 22) and without flap (NF group, n = 20), aged 40 to 58 years. The main outcome measure was the apnea-hypopnea index (AHI), measured by in-lab nocturnal polysomnography (PSG). The OSA-related symptoms were investigated by Pittsburgh, Epworth, and Berlin questionnaires. The nasopharyngeal or velopharyngeal (NP/VP) cross-sectional area was measured by modified anterior rhinomanometry in subgroups of the F (n = 14) and NF (n = 10) groups at rest and during speech. Differences were considered significant at P < .05.
Questionnaire scores and frequency of self-reported symptoms of snoring, nasal obstruction, and breathing interruptions during sleep did not differ between groups. OSA was diagnosed by PSG in 60% and 77% of the NF and F subjects, respectively. The difference was not significant. No cases of severe OSA were observed. There was no correlation between AHI and NP/VP area.
A significant number of middle-aged adults with repaired cleft palate had OSA and related symptoms, regardless of the presence of a pharyngeal flap. Results suggest that VPI treatment with a flap may not cause sleep-disordered breathing in the cleft population. Besides advancing age, congenital upper airway abnormalities may be involved.
比较因腭咽闭合不全（VPI）接受咽瓣手术的中年成年人与未接受咽瓣手术的匹配受试者中阻塞性睡眠呼吸暂停（OSA）的发生率和严重程度，并验证OSA严重程度与咽内部尺寸之间的关系。
国家唇腭裂转诊护理中心。
对42名年龄在40至58岁之间、患有非综合征性腭裂且已修复的受试者进行前瞻性研究，其中接受咽瓣手术的为F组（n = 22），未接受咽瓣手术的为NF组（n = 20）。主要观察指标为通过实验室夜间多导睡眠图（PSG）测量的呼吸暂停低通气指数（AHI）。通过匹兹堡、爱泼华和柏林问卷调查OSA相关症状。在F组（n = 14）和NF组（n = 10）的亚组中，于静息状态和言语期间通过改良前鼻测压法测量鼻咽或腭咽（NP/VP）横截面积。P < 0.05时差异被认为具有统计学意义。
两组间问卷得分以及自我报告的打鼾、鼻塞和睡眠期间呼吸中断症状的发生率无差异。NF组和F组分别有60%和77%的受试者通过PSG诊断为OSA。差异无统计学意义。未观察到严重OSA病例。AHI与NP/VP面积之间无相关性。
大量中年腭裂修复患者存在OSA及相关症状，无论是否存在咽瓣。结果表明，咽瓣治疗VPI可能不会导致腭裂人群出现睡眠呼吸紊乱。除了年龄增长外，先天性上呼吸道异常可能也有影响。
