The effectiveness of tonsillectomy and partial adenoidectomy on obstructive sleep apnea in cleft palate patients

Abdel‐Aziz, Mosaad

doi:10.1002/lary.23507

Cited by 22 publications

(16 citation statements)

References 26 publications

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“…In some children with craniofacial disorders, OSAS can be successfully treated with surgeries such as adenotonsillectomy 20 or selective craniofacial procedures such as mandibular distraction osteogenesis 21 . In other cases, continuous positive pressure airway pressure (CPAP) can be used to effectively treat OSAS 22 and in extreme cases, tracheostomy may be necessary.…”

Section: Discussionmentioning

confidence: 99%

Utility of Screening for Obstructive Sleep Apnea Syndrome in Children with Craniofacial Disorders

Cielo

Silvestre

Paliga

et al. 2014

Plastic and Reconstructive Surgery

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Background Children with craniofacial disorders are at increased risk for obstructive sleep apnea syndrome (OSAS). Methods for diagnosing OSAS in this population remain controversial. Sleep studies are the gold standard but are impractical for all patients. The utility of OSAS questionnaires like the Pediatric Sleep Questionnaire (PSQ) is unknown in children with craniofacial disorders. We hypothesized that the PSQ would be a sensitive tool for detecting OSAS in children with craniofacial abnormalities. Methods A retrospective review of consecutive children with diagnosed craniofacial disorders who both completed the PSQ and had a polysomnogram (PSG) was performed. Demographics, PSQ score, and PSG data were recorded. Statistical analysis included calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) for the PSQ. Results 83 children 2–18 years old were included in the study. Of these, 44 (53.0%) screened positive on the PSQ and 23 (27.7%) had PSG evidence of OSAS, but the sensitivity of the PSQ for detecting OSAS in this sample was only 0.57 and the specificity was 0.48. PPV and NPV were 0.30 and 0.74, respectively. The correlation between the apnea hypopnea index and PSQ score was 0.152 (p=0.17). Conclusions A substantial portion of craniofacial patients referred for PSG was found to have OSAS. However, the PSQ is not a good screening tool for OSAS in children with craniofacial conditions. More research is needed to determine which patients with craniofacial disorders should be evaluated for OSAS by PSG or other means. LEVEL OF EVIDENCE Diagnostic, III

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Section: Discussionmentioning

confidence: 99%

Utility of Screening for Obstructive Sleep Apnea Syndrome in Children with Craniofacial Disorders

Cielo

Silvestre

Paliga

et al. 2014

Plastic and Reconstructive Surgery

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“…With adenoidectomy, there is the potential risk for exacerbating velopharyngeal insufficiency, so some surgeons favor a procedure that involves removing the superior and leaving the inferior rim of the adenoid tissue to maintain speech. One study found that in children with cleft palate who had primary palatoplasty, tonsillectomy and/or partial adenoidectomy was generally effective, but the cleft status and surgical techniques varied considerably among the 17 patients 36 . In children with Down syndrome, adenotonsillectomy should be considered as a first-line therapy in children with OSAS, but it has a much lower success rate than in otherwise healthy children 33 .…”

Section: Therapies For Osas In the Paediatric Craniofacial Populationmentioning

confidence: 99%

Obstructive sleep apnoea in children with craniofacial syndromes

Cielo

Marcus

2015

Paediatric Respiratory Reviews

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Summary Obstructive sleep apnoea syndrome (OSAS) is common in children. Craniofacial anomalies such as cleft palate are among the most common congenital conditions. Children with a variety of craniofacial conditions, including cleft palate, micrognathia, craniosynostosis, and midface hypoplasia are at increased risk for OSAS. Available evidence, which is largely limited to surgical case series and retrospective studies, suggests that OSAS can be successfully managed in these children through both surgical and non-surgical techniques. Prospective studies using larger cohorts of patients and including polysomnograms are needed to better understand the risk factors for this patient population and the efficacy of treatment options for OSAS and their underlying conditions.

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“…These children have a short palate and typically have palatal dysfunction [ 4 ]. Because the long-term sequelae of SDB can be debilitating from a behavioral standpoint and dangerous from a cardiopulmonary standpoint, surgical intervention is generally necessary even though adenoidectomy has classically been approached with caution in patients with cleft palate [ 5 ]. Superior adenoidectomy is indicated in these cases to preserve the patient’s speech while removing the bulk of the choanal obstruction.…”

Section: Discussionmentioning

confidence: 99%

Sleep and Speech Outcomes After Superior Adenoidectomy in Children with Cleft Palate

Waselchuk

Sidman

Lander

et al. 2018

Cureus

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The effectiveness of tonsillectomy and partial adenoidectomy on obstructive sleep apnea in cleft palate patients

Cited by 22 publications

References 26 publications

Utility of Screening for Obstructive Sleep Apnea Syndrome in Children with Craniofacial Disorders

Utility of Screening for Obstructive Sleep Apnea Syndrome in Children with Craniofacial Disorders

Obstructive sleep apnoea in children with craniofacial syndromes

Sleep and Speech Outcomes After Superior Adenoidectomy in Children with Cleft Palate

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