Prevalence of Obstructive Sleep Apnea After Orticochea Pharyngoplasty for Velopharyngeal Insufficiency Management.

BACKGROUND AND PURPOSE: The aim of this study is to describe the prevalence of obstructive sleep apnea (OSA) and its level of severity associated with Orticochea pharyngoplasty in patients with velopharyngeal insufficiency after at least 1 year of the surgical procedure.

DESIGN: Case series prospective descriptive study.

MAIN OUTCOME MEASURES: At FISULAB, a rehabilitation center for patients with cleft palate, we studied 37 patients who were treated elsewhere with Orticochea pharyngoplasty for velopharyngeal insufficiency; these patients may or may not have had clinical symptoms related to OSA. All participants underwent a polysomnography sleep study, which was also done in different institutions. We applied the Epworth Sleepiness Scales during the clinical investigation because it is an effective instrument used to measure average daytime sleepiness. Another questionnaire to identify cases of OSA was used. Among other variables studied, the apnea/hypopnea index was the main outcome, while age and type of cleft were secondary variables.

RESULTS: From 37 patients who were studied (100%), we obtained the following results: normal apnea/hypopnea index: seven patients (18.9%); mild apnea/hypopnea index: 14 patients (37.8%); moderate apnea/hypopnea index: eight patients (21.6%); and severe apnea/hypopnea index: eight patients (21.6%).

CONCLUSIONS: In this study, we found that more than three quarters (81%) of the patients who were treated for velopharyngeal insufficiency with Orticochea pharyngoplasty presented obstructive sleep apnea when analyzing the apnea/hypopnea index in the polysomnography sleep study.