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Related Experiment Videos

Robin sequence: obstructive sleep apnea following pharyngeal flap

D L Abramson1, E M Marrinan, J B Mulliken

  • 1Department of Otolaryngology and Communication Disorders, Children's Hospital, Boston, Massachusetts, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|May 1, 1997
PubMed
Summary

For Robin sequence patients, V-Y palate repair showed low velopharyngeal dysfunction (VPD). However, the von Langenbeck repair led to higher VPD rates and obstructive sleep apnea after pharyngeal flap surgery.

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Area of Science:

  • Craniofacial surgery
  • Pediatric otolaryngology
  • Speech pathology

Background:

  • Robin sequence (RS) is a congenital condition affecting facial development, often involving a cleft palate.
  • Velopharyngeal dysfunction (VPD) is a common complication following cleft palate repair, impacting speech intelligibility.
  • Pharyngeal flap surgery is a common intervention for VPD, but carries potential risks.

Purpose of the Study:

  • To evaluate the speech outcomes and velopharyngeal function after different cleft palate repair techniques in children with Robin sequence.
  • To assess the incidence of obstructive sleep apnea (OSA) following pharyngeal flap surgery in this patient cohort.

Main Methods:

  • Retrospective review of 24 children with Robin sequence who underwent cleft palate repair.

Related Experiment Videos

  • Palatal closure performed between 9 and 14 months using either V-Y repair (n=16) or von Langenbeck repair (n=8).
  • Speech and velopharyngeal function assessed in patients aged 5 years or older.

    • Main Results:

    • Only 1 of 16 children (6.3%) undergoing V-Y repair experienced borderline velopharyngeal dysfunction (VPD).
    • Six of eight children (75%) who had von Langenbeck repair developed VPD, with four requiring pharyngeal flap surgery.
    • In nonsyndromic Robin sequence patients, 6 of 7 (85.7%) who had palatoplasty and pharyngeal flap developed obstructive sleep apnea (OSA), necessitating flap takedown.

    Conclusions:

    • Conventional pharyngeal flap surgery for VPD in nonsyndromic Robin sequence children is associated with a high incidence of obstructive sleep apnea.
    • Alternative management strategies for VPD in these patients should be considered, including modified pharyngeal flaps, palatal lengthening techniques (V-Y or double-opposing Z-plasty), or speech bulbs.