Obstructive sleep apnea following treatment of velopharyngeal incompetence by Teflon injection

From 1967 to 1974 a clinical trial of Teflon injection into the posterior pharyngeal wall for correction of velopharyngeal incompetence (VPI) was conducted in thirty-six patients. Six years after Teflon injection, one of the patients reported the onset of severe snoring punctuated by silences when he seemed not to be breathing, daytime hypersomnolence, and tiredness severe enough to interfere with work and studies. The diagnosis of obstructive sleep apnea (OSA) was confirmed by polysomnographic sleep monitoring, and the dynamics of the obstruction elucidated by cinefluoroscopy performed with the patient asleep. Resection of the lower 3/4 of the Teflon pad, leaving the upper rim to avoid recurrence of his VPI, has eliminated the symptoms of OSA and produced an improvement in his polysomnographic findings.