Palatoplasty as the Technique of Choice for Prevention of Obstructive Sleep Apnea Secondary to Surgery for Velopharyngeal Insufficiency

Abstract

When comparing the apnea-hypopnea index (i.e., respiratory disturbance index) of patients treated for velopharyngeal insufficiency with palatoplasty versus pharyngoplasty, we observed an important difference between the groups, with the highest indices in the pharyngoplasty group.

Rates of Revision and Obstructive Sleep Apnea after Surgery for Velopharyngeal Insufficiency: A Longitudinal Comparative Analysis of More Than 1000 Operations

“…Many retrospective studies have published rates of obstructive sleep apnea following pharyngeal flap surgery 6,7,16–18 and sphincter pharyngoplasty 5,19,20 alone or in comparison to palatal lengthening. However, only a handful of studies over the past three decades have directly compared obstructive sleep apnea rates between pharyngoplasty procedures.…”

Craniofacial syndromes and sleep-related breathing disorders

“…However, a recent international multicenter randomized trial did not reveal any significant difference between the 2 procedures (68). Furlow palatoplasty does however appear to have a lower OSA complication rate - in a small study of 20 patients, 1 of the 10 patients who underwent Furlow palatoplasty had mild OSA, while of the 10 patients who underwent pharyngoplasty, 2 had mild OSA, 1 moderate, and 2 severe OSA (69). This has led one center to advocate Furlow palatoplasty for overt clefts and kinetic submucous cleft palates, and pharyngeal flap to treat akinetic palates and persistent velopharyngeal insufficiency after Furlow palatoplasty (70).…”

Does division of pharyngeal flap operated for correction of velopharyngeal insufficiency affects speech results?

“…Bu obstrüktif yakınmaların başında horlama ve flebin oluşturduğu statik engele sekonder görülen obstrüktif uyku apnesi gelmektedir (24,25) . Obstrüktif uyku apnesinin tedavisinde ilk basamak gece uygulanan oksijen desteğidir (26) .…”