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Snoring in cleft patients with velopharyngoplasty
J Rustemeyer1, V Thieme, A Bremerich
1Department of Cranio-Maxillofacial Surgery, Klinikum Bremen Mitte, Bremen, Germany. janrustem@t-online.de
International Journal of Oral and Maxillofacial Surgery
|September 11, 2007
Summary
Velopharyngoplasty (VPP) in cleft palate patients may lead to snoring due to narrowed posterior airway space (PAS). This study found VPP significantly impacts PAS dimensions, increasing obstructive sleep apnea risk.
Area of Science:
- Craniofacial surgery
- Sleep medicine
- Pediatric dentistry
Background:
- Patients with cleft lip/palate (CLP) or isolated cleft palate (ICP) may develop snoring after velopharyngoplasty (VPP).
- Snoring can be a symptom of obstructive sleep apnea syndrome (OSAS).
- The impact of VPP on the posterior airway space (PAS) and its correlation with snoring requires further investigation.
Purpose of the Study:
- To determine if there is a difference in the posterior airway space (PAS) between CLP/ICP patients with snoring after VPP and those without snoring.
- To compare PAS dimensions in patients who underwent VPP with control groups.
Main Methods:
- Lateral cephalograms of 20 CLP/ICP patients who underwent VPP and snored were analyzed for PAS dimensions.
- Comparison groups included 40 non-cleft patients undergoing orthodontic treatment and 20 CLP/ICP patients without VPP.
- Four standard PAS parameters were measured.
Main Results:
- Significant differences in metric parameters of PAS were observed between CLP/ICP patients with snoring post-VPP and those without snoring.
- All cleft patients exhibited at least one dimension of PAS constriction compared to non-cleft patients.
- VPP appeared to induce further narrowing of the PAS in snoring patients.
Conclusions:
- CLP/ICP patients generally have narrower PAS, predisposing them to airway issues.
- VPP may exacerbate PAS narrowing, potentially inducing or worsening snoring and OSAS.
- Mandatory screening and analysis for OSAS are recommended for CLP/ICP patients, especially after VPP.
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