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The effectiveness of tonsillectomy and partial adenoidectomy on obstructive sleep apnea in cleft palate patients

Mosaad Abdel-Aziz1

  • 1Department of Otolaryngology, Faculty of Medicine, Cairo University, Egypt. mosabeez@yahoo.com

The Laryngoscope
|September 7, 2012
PubMed

Insights

Tonsillectomy and/or partial adenoidectomy significantly improved obstructive sleep apnea (OSA) in cleft palate patients with adenotonsillar hypertrophy (ATH). Most patients showed normalized apnea/hypopnea indexes post-surgery, with no adverse speech effects.

Area of Science:

  • Otolaryngology
  • Pediatric Sleep Medicine
  • Craniofacial Surgery

Background:

  • Adenotonsillar hypertrophy (ATH) is a primary cause of pediatric obstructive sleep apnea (OSA).
  • Cleft palate patients have narrower airways, exacerbating OSA severity from ATH.
  • Surgical intervention for OSA in cleft palate patients requires careful consideration of speech outcomes.

Purpose of the Study:

  • To evaluate the efficacy of tonsillectomy and/or partial adenoidectomy in treating OSA in cleft palate patients.
  • To assess the impact of surgery on apnea/hypopnea index and oxygen saturation.
  • To monitor for potential speech impairments following pharyngeal surgery.

Main Methods:

  • A case series involving 17 repaired cleft palate patients with ATH and OSA.
  • Pre- and post-operative measurements of apnea/hypopnea index and minimum O2 saturation.
  • Auditory perceptual and nasometric speech assessments were conducted.

Main Results:

  • Significant improvement in apnea/hypopnea index (17.6 to 1.9) and O2 saturation (88.7% to 93.7%) post-surgery (P < 0.001).
  • 70.6% of patients achieved normalized apnea/hypopnea indexes.
  • No significant changes in speech assessments were observed.

Conclusions:

  • Tonsillectomy and/or partial adenoidectomy is effective for OSA in cleft palate patients with ATH.
  • Associated comorbidities may necessitate further interventions for complete airway obstruction relief.
  • Surgical treatment did not negatively impact speech in this cohort.
Abstract

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