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Septoplasty for obstructive sleep apnea in infants after cleft lip repair
G D Josephson1, J Levine, C B Cutting
1New York Eye and Ear Infirmary, Department of Otolaryngology-Head and Neck Surgery, New York, USA.
Insights
Unilateral cleft lip and palate can cause deviated nasal septum and obstructive sleep apnea (OSA) post-repair. Conservative septal correction relieved OSA in two pediatric patients, highlighting a potential treatment pathway.
Area of Science:
- Pediatric surgery
- Otolaryngology
- Craniofacial anomalies
Background:
- Unilateral cleft lip and palate often results in deviated nasal septum due to asymmetric bony development.
- While clefts provide an airway, septal deviation can lead to nasal obstruction and obstructive sleep apnea (OSA), particularly after surgical repair.
- Surgical correction of septal deformities in children is debated due to potential impacts on facial growth.
Abstract:
A neonate with a unilateral cleft lip and palate usually presents with a deviated nasal septum due to the asymmetric bony base associated with cleft palate. Prior to repair, the facial cleft offers a wide open breathing passage despite the septal deviation. Cleft lips are traditionally repaired in neonates at about 3 months of age. These patients usually do not present with significant symptoms of nasal obstruction following repair, except in unusual cases. Severe septal deviation may cause obstructive sleep apnea. Repair of septal deformities in children is controversial due to the potential alteration of facial growth. We present two patients with documented obstructive sleep apnea that began after cleft lip repair. Conservative surgical correction of the septal deviation resulted in relief of the sleep apnea.