Palatoplasty as the technique of choice for prevention of obstructive sleep apnea secondary to surgery for velopharyngeal insufficiency.
OBJECTIVE
The aim of this study is to compare patients treated with pharyngoplasty and those treated with palatoplasty for velopharyngeal insufficiency to establish what surgical procedure poses the highest risk for developing sleep apnea. The hypothesis tested in this study is that the incidence of obstructive sleep apnea syndrome associated with pharyngoplasty is greater than that associated with palatoplasty for velopharyngeal insufficiency.


METHODS
Twenty patients were taken from the Institution FISULAB.


METHODS
Observational cohort analytic study.


METHODS
An overnight polysomnographic study was used to determine the incidence and severity of obstructive sleep apnea syndrome.


RESULTS
The incidence of obstructive sleep apnea syndrome following pharyngoplasty was shown to be significantly higher than after palatoplasty. The apnea-hypopnea index, also called the respiratory disturbance index, was 12.7 in the pharyngoplasty group and 1.35 in the palatoplasty group (p < .001). When obstructive sleep apnea syndrome was stratified into different levels of severity according to the values of respiratory disturbance index, there were noticeable differences between these two groups. In the palatoplasty group, one patient had mild obstructive sleep apnea syndrome. In the pharyngoplasty group, two patients had mild obstructive sleep apnea syndrome, one patient had moderate obstructive sleep apnea syndrome, and two patients had severe obstructive sleep apnea syndrome.


CONCLUSIONS
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.
Madrid
Jose Rolando Prada
JR
Eduardo Nieto
Luis
L
Gomez
Viviana
V
Echeverry
Pilar
P
Tavera
Maria Cristina
MC
Oliveros
Henry
H
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010159:Palate / Q000503:physiopathology / Q000601:surgery*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery*