title: Unilateral Craniofacial Microsomia: Unrecognized Cause of Pediatric Obstructive Sleep Apnea.
abstract: Bilateral craniofacial microsomia causes obstructive sleep apnea (OSA). We hypothesize that unilateral craniofacial microsomia (UCFM) is an underappreciated cause of OSA. The records of all pediatric UCFM patients from 1990 to 2010 were reviewed; only complete records were included in the study. UCFM patients with OSA (apnea hypopnea index >1/hr) were compared to UCFM patients without OSA. Univariate and multivariate Fisher and χ(2) tests were performed. Of the 62 UCFM patients, 7 (11.3%) had OSA. All OSA patients had Pruzansky IIB or III mandibles. OSA patients presented with snoring (71.4%), failure to thrive (FTT) (57.1%), and chronic respiratory infections (42.8%). Snoring (P < 0.001), Goldenhar syndrome (P = 0.001), and FTT (P = 0.004) were significantly associated with OSA, but race, obesity, clefts, respiratory anomalies, adenotonsillar hypertrophy, and laterality were not. The prevalence of OSA in UCFM patients is up to 10 times greater than in the general population. Snoring, Goldenhar syndrome, and FTT are significantly associated with the presence of OSA.
authors.affiliation: *Department of Plastic Surgery, New York University Langone Medical Center, New York, NY †Department of Neurological Surgery/The Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY ‡Department of Surgery, Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Caroline
authors.initials: C
authors.lastname: Szpalski
authors.forename: Meredith
authors.initials: M
authors.lastname: Vandegrift
authors.forename: Parit A
authors.initials: PA
authors.lastname: Patel
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Appelboom
authors.forename: Mark
authors.initials: M
authors.lastname: Fisher
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Marcus
authors.forename: Joseph G
authors.initials: JG
authors.lastname: McCarthy
authors.forename: Pradip R
authors.initials: PR
authors.lastname: Shetye
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Warren
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006053:Goldenhar Syndrome / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D017286:Polysomnography / Q000379:methods*; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology