Fatty hypertrophy cause obstructive sleep apnea after fat injection for velopharyngeal incompetence.
METHODS
Soft tissue augmentation of the posterior pharyngeal wall and the soft palate is reported to reduce velopharyngeal incompetence, and fat grafting in selected patients has shown effective and lasting results for restoring normal resonance. Potential complications of soft tissue augmentation for velopharyngeal incompetence include obstructive sleep apnea.


METHODS
An 8-year-old boy with velopharyngeal incompetence and a small velopharyngeal gap underwent a fat injection procedure and subsequently developed obstructive sleep apnea concomitant with a significant weight gain. Videofluoroscopy and nasendoscopy showed a remarkable enlargement of the grafted fat areas that required a soft palate debulking procedure, significantly improving obstructive sleep apnea.


CONCLUSIONS
This is an unusual case where alteration in volume of grafted fat at the recipient site is suspected of causing obstructive sleep apnea. It is also an example of long-term fat graft survival and fat graft overgrowth.
Teixeira
Rodrigo P
RP
Reid
Julie A
JA
Greensmith
Andrew
A
D000015:Abnormalities, Multiple / Q000601:surgery; D000273:Adipose Tissue / Q000637:transplantation*; D064592:Autografts / Q000637:transplantation*; D001941:Breast Diseases / Q000601:surgery; D002648:Child; D002933:Cineradiography / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006984:Hypertrophy; D008297:Male; D010160:Palate, Soft / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D011183:Postoperative Complications; D020181:Sleep Apnea, Obstructive / Q000209:etiology*; D013060:Speech / Q000502:physiology; D014457:Ulna / Q000002:abnormalities / Q000601:surgery; D014681:Velopharyngeal Insufficiency / Q000601:surgery*