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Examination of Respiratory Disturbance Index Before and After Cheiloplasty and Palatoplasty

Ryo Murasugi1, Hitoshi Kawanabe2, Ayano Murakami2

  • 1Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University School of Dentistry, Fukushima 963-8041, Japan.

Diseases (Basel, Switzerland)
|March 26, 2025
PubMed

Insights

Surgery for infants with unilateral cleft lip and/or palate (UCLP) significantly improves sleep-disordered breathing (SDB). These surgical procedures, cheiloplasty and palatoplasty, reduce the respiratory disturbance index (RDI) in infants with UCLP.

Area of Science:

  • Pediatric surgery
  • Sleep medicine
  • Craniofacial anomalies

Background:

  • Pediatric sleep-disordered breathing (SDB) is underdiagnosed but can lead to significant developmental issues.
  • Cleft lip and/or palate (CLP) is a common congenital condition and a known risk factor for SDB.
  • Infants with unilateral cleft lip and/or palate (UCLP) are particularly susceptible to SDB.

Purpose of the Study:

  • To evaluate the impact of surgical interventions on SDB in infants with UCLP.
  • To assess changes in sleep breathing patterns before and after cheiloplasty and palatoplasty.
  • To determine if surgical repair mitigates SDB-related complications in UCLP infants.

Main Methods:

  • Prospective before-after study design.
  • Inclusion of infants with UCLP undergoing sleep breathing tests.
  • Assessment of sleep breathing using a fiber-based sleep apnea sensor pre- and post-surgery.

Main Results:

  • Cheiloplasty led to a significant reduction in the respiratory disturbance index (RDI) from 7.5 to 2.7 events/h (p=0.007).
  • Palatoplasty also significantly decreased the RDI from 4.4 to 1.7 events/h (p=0.010).
  • Both surgical procedures demonstrated a marked improvement in SDB metrics.

Conclusions:

  • Cheiloplasty and palatoplasty are effective in improving SDB in infants with UCLP.
  • Surgical repair of UCLP can alleviate adverse effects on infant physical growth and development.
  • Early surgical intervention is crucial for managing SDB in this vulnerable population.

Keywords:
Fiber-Based Sleep Apnea Syndrome Sensor®cheiloplastycleft lip and palateinfantsout-of-center sleep testingpalatoplastypediatric sleep-disordered breathingrespiratory disturbance indexsleep apnea

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