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Obstructive sleep apnea in children with nonsyndromic cleft palate: a systematic review

W Nicholas Jungbauer1, Nicolas S Poupore1, Shaun A Nguyen1

  • 1Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, Charleston, South Carolina.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|April 23, 2022
PubMed

Insights

Obstructive sleep apnea (OSA) is common in children with nonsyndromic cleft palate, often presenting as mild to moderate after surgery. Further research is needed to understand the full impact of palatoplasty on OSA in this population.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Craniofacial Surgery

Background:

  • Obstructive sleep apnea (OSA) is a significant concern in children with nonsyndromic cleft palate.
  • The impact of primary palatoplasty on OSA in this population requires further characterization.

Purpose of the Study:

  • To systematically review and characterize obstructive sleep apnea in children with nonsyndromic cleft palate.
  • To analyze polysomnographic parameters in relation to primary palatoplasty.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searched PubMed, Scopus, CINAHL, and Cochrane databases.
  • Included studies exclusively on nonsyndromic cleft palate patients with polysomnogram data.

Main Results:

  • Seven studies with 151 patients (mean age 5.2 years) were analyzed.
  • Pre-palatoplasty mean apnea-hypopnea index (AHI) was 11.4 events/h; post-palatoplasty mean AHI was 1.5 events/h.
  • Limited data showed no significant AHI change after surgery, with post-operative AHI indicating mild to moderate OSA.

Conclusions:

  • The effect of cleft palate repair on OSA in children with nonsyndromic cleft palate is understudied.
  • Published data, though heterogeneous, suggest palatoplasty does not consistently worsen OSA.
  • Standardized polysomnographic studies are needed for management guidance.
Abstract

Keywords:
apnea-hypopnea indexcleft palateobstructive sleep apneapalatoplastypediatric

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