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Published on: December 6, 2016
Robin Sequence and Isolated Cleft Palate are Associated With a High Prevalence of Obstructive Sleep Apnea in
Fábio Luiz Banhara1, Ivy Kiemle Trindade-Suedamm1,2, Inge Elly Kiemle Trindade1,2
1Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), Univerity of São Paulo, Bauru, Brazil.
Insights
Children with nonsyndromic Robin sequence (NSRS) and nonsyndromic cleft palate (NSCP) exhibit high rates of mild to moderate obstructive sleep apnea (OSA). Early screening for sleep-disordered breathing is crucial for these pediatric populations.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Sleep Medicine
Background:
- Nonsyndromic Robin sequence (NSRS) and nonsyndromic cleft palate (NSCP) are congenital conditions that can affect craniofacial development.
- Obstructive sleep apnea (OSA) is a common sleep-disordered breathing condition in children, potentially exacerbated by airway anomalies.
Purpose of the Study:
- To determine the prevalence of obstructive sleep apnea (OSA) in children aged 6 to 12 years with NSRS and NSCP.
- To compare OSA frequency between these two pediatric groups.
Main Methods:
- A cross-sectional study was conducted involving 146 children (69 with NSRS, 77 with NSCP) presenting with complete cleft palate.
- Evaluations included anthropometric, dentoskeletal, and facial analyses, clinical interviews using validated sleep disturbance and congestion scales, and Type IV polysomnography in a subset of patients.
Main Results:
- OSA was detected in 59.42% of children with NSRS and 46.75% with NSCP (P > .05).
- Polysomnography revealed mild to moderate OSA indicators in 89.65% of the NSRS group and 78.94% of the NSCP group.
- Facial and pharyngeal alterations were associated with OSA in both groups.
Conclusions:
- Children with NSRS and NSCP demonstrate a high prevalence of mild to moderate obstructive sleep apnea.
- Systematic evaluation for sleep-disordered breathing is recommended for pediatric patients with NSRS and NSCP.
Abstract:
ObjectiveTo analyze the prevalence of obstructive sleep apnea (OSA) in children aged 6 to 12 years with nonsyndromic Robin sequence (NSRS) and in those with nonsyndromic cleft palate (NSCP). All patients presented complete cleft palate (Veau II).DesignCross-sectional study.SettingTertiary public hospital.PatientsA total of 146 children divided into 2 groups: (1) NSRS (n = 69), (2) NSCP (n = 77).Interventions(1) Anthropometric assessment, dentoskeletal, and facial analysis. (2) Clinical interview with "Sleep Disturbance Scale for Children" and "Congestion Quantifier Five-Item" (CQ5); and (3) 48 patients: Type IV polysomnography.Main Outcome MeasuresFrequency of OSA in children with NSRS and NSCP, assessed by Type IV polysomnography.ResultsPositive scores for OSA were found in 59.42% of children with NSRS and 46.75% of those with NSCP (P > .05). Excessive daytime sleepiness was observed in 23.19% of the NSRS group and 9.01% of the NSCP group (P > .05). Positive scores for nasal obstruction were noted in 14.49% with NSRS and 20.78% of those with NSCP (P > .05). In polysomnography IV subgroups, an Oxygen Desaturation Index compatible with mild to moderate OSA was observed in 89.65% of the NSRS group and 78,94% of the NSCP group (P > .05). Also, facial and pharyngeal alterations, such as Angle Class II malocclusion, Mallampati classifications III and IV, and deep crossbite, were associated with OSA.ConclusionBoth children with NSRS and NSCP have a high frequency of mild to moderate OSA, highlighting the need for systematic evaluation of the presence of sleep-disordered breathing in this population.
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