China Journal of Oral and Maxillofacial Surgery ›› 2021, Vol. 19 ›› Issue (1): 76-81.doi: 10.19438/j.cjoms.2021.01.015

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A retrospective analysis of sleep breathing disordered after pharyngoplasty for velopharyngeal insufficiency secondary to cleft palate

ZHAO Xin-ran, CAI Ming   

  1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2020-02-20 Revised:2020-05-28 Online:2021-01-20 Published:2021-02-19

Abstract: ] The commonly used surgical methods for velopharyngeal insufficiency secondary to cleft palate include pharyngeal flap, sphincter pharyngoplasty and Furlow palatoplasty (double-opposing Z-plasty). Polysomnography (PSG) combined with the chief complaints indicated that some patients who had underwent pharyngoplasty for velopharyngeal insufficiency would have different levels of obstructive sleep apnea-hypopnea syndrome (OSAHS). Some patients with mild symptoms could be relieved by themselves, while those with severe symptoms need to be treated by oxygen inhalation or continuous positive airway pressure(CPAP), and very few had to have the flap removed or loosened through another surgery. There was no significant difference in the morbidity of OSAHS between children and adults, but the condition of children was more serious than that of adults. Patients with preoperative OSAHS might have their symptoms aggravated after surgery. In the short-term follow-up (≤6 months) of patients with different surgical procedures, the incidence of OSAHS was the lowest in Furlow palatoplasty, followed by sphincter pharyngoplasty, and the highest was posterior pharyngeal flap. However, long term follow-up (>12 months) demonstrated that there was no significant difference in the morbidity. At present, there is no unified operation for velopharyngeal insufficiency secondary to cleft palate, and the morbidity of OSAHS after various operation methods is still controversial. PSG should be applied as a routine examination during the perioperative period of pharyngoplasty, so as to evaluate the impact of different operation methods on sleep disordered breathing more accurately.

Key words: Pharyngoplasty, Obstructive sleep apnea-hypopnea syndrome, Pharyngeal flap, Sphincter pharyngoplasty, Furlow palatoplasty

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