Sobral Davi Sandes, Faller Gustavo Juliane, Collares Marcus Vinícius Martins
1 Otorhinolaringology Division, Santo Antonio Hospital (OSID-Nun Dulce`s Beneficent Institution), Salvador, BA, Brasil.
2 Craniomaxillofacial division of Porto Alegre Clinics Hospital.
Cleft Palate Craniofac J. 2018 Feb;55(2):287-291. doi: 10.1177/1055665617726538. Epub 2017 Dec 14.
Cleft lip and palate (CLP) is the most common congenital craniofacial abnormality. Obstructive sleep apnea syndrome (OSAS) is a highly prevalent but underdiagnosed disease and is frequently associated with craniofacial anomalies. There are few studies describing the sleep breathing pattern of children with CLP. This study sought to characterize the respiratory profile of 23 children with unilateral cleft lip and palate, aged 7-12 years, who had undergone cleft lip and nasal repair at age 3-4 months and palatoplasty at 12-15 months, with a particular focus on evaluating the presence of OSAS in children with CLP. Polysomnography was performed and findings were analyzed descriptively. We found a mean and median for apnea/hypopnea index (AHI) of 1.11/h (SD = 0.78) and 0.9/h, respectively. The mean obstructive apnea index (OAI) was 0.27/h (SD = 0.38) and the median, 0.1/h. Nearly 30% of patients had an AHI above 1.4 events/h. There was no significant oxyhemoglobin desaturation in the study group. In this group, the prevalence of OSAS was higher than in noncleft populations when compared to the normality values adopted. This sample of patients with unilateral cleft lip and palate exhibited an increased prevalence of OSAS during the mixed dentition stage. Although the results showed that OSAS was mild, we advise closer observation of these patients. Polysomnography is recommended for the assessment of children with airway abnormalities, to individualize the extent of treatment.
唇腭裂(CLP)是最常见的先天性颅面畸形。阻塞性睡眠呼吸暂停综合征(OSAS)是一种高度流行但诊断不足的疾病,且常与颅面畸形相关。很少有研究描述唇腭裂患儿的睡眠呼吸模式。本研究旨在描述23名7至12岁单侧唇腭裂患儿的呼吸特征,这些患儿在3至4个月时接受了唇裂和鼻修复手术,在12至15个月时接受了腭裂修复手术,特别关注评估唇腭裂患儿中OSAS的存在情况。进行了多导睡眠图检查,并对结果进行了描述性分析。我们发现呼吸暂停/低通气指数(AHI)的均值和中位数分别为1.11次/小时(标准差=0.78)和0.9次/小时。平均阻塞性呼吸暂停指数(OAI)为0.27次/小时(标准差=0.38),中位数为0.1次/小时。近30%的患者AHI高于1.4次/小时。研究组中没有明显的氧合血红蛋白饱和度下降。与所采用的正常数值相比,该组中OSAS的患病率高于非腭裂人群。这组单侧唇腭裂患者在混合牙列期OSAS的患病率有所增加。尽管结果显示OSAS为轻度,但我们建议对这些患者进行密切观察。建议对气道异常的儿童进行多导睡眠图检查,以个体化治疗程度。