Cephalometric assessment of the posterior airway space in patients with cleft palate after palatoplasty.

OBJECTIVE: Upper airway obstruction and mouth breathing influence facial growth and development, which may result in breathing disorders while asleep. The purpose of the present investigation was to analyze cephalometric alterations between patients with cleft palate and a noncleft control group in an obstructive sleep disordered breathing-specific tracing. SETTING: The study was conducted in the cleft palate clinic of a university hospital. PARTICIPANTS: Fifty-three subjects with a mean age of 12.3 +/- 3.7 years (range 6.3 to 17.2 years). The cohort included 33 subjects (13 females, 20 males; mean age 12.1 +/- 3.8 years, mean body mass index 17.5 +/- 2.9 kg/m(2)) with surgical closure of a unilateral or bilateral cleft palate and a matched control of noncleft participants. None of the subjects suffered from sleep disordered breathing syndrome. RESULTS: Compared with the controls, patients with cleft palate had a significant narrow anterior-posterior dimension of the pharynx at the level of the maxillary plane and the narrowest width, a more downward hyoid position, and a longer uvula. CONCLUSIONS: Patients with cleft palate appear to present pharyngeal and craniofacial distinctive features that characterize patients with obstructive sleep disordered breathing and differ from those of a noncleft control.

Sleep-related obstructive disordered breathing in cleft palate patients after palatoplasty.

Sleep-disordered breathing is frequently associated with children presenting congenital midface defects. Because of structural and functional anomalies in the upper airway, children with cleft palate, especially after surgery, may carry a higher risk of developing sleep-disordered breathing. However, the presence of such sleep-disordered breathing in older cleft palate children has not been emphasized. The aim of this comparative overnight cardiorespiratory sleep study was to evaluate cleft palate patients according to sleep-disordered breathing. A group of 43 cleft palate children (17 girls and 26 boys; mean age, 12.1 +/- 3.8 years) was compared with a control group of 20 randomly selected, noncleft children matched for age, sex, and body mass index. None of the patients suffered from manifest sleep-disordered breathing. Cleft palate patients had a statistically significantly higher respiratory disturbance index and snoring index, but no increased apnea index. The data suggest that cleft palate patients having undergone primary closure of the palate demonstrate microsymptoms of nocturnal upper airway obstruction.