Logo image
Back
Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea
Journal article   Open access   Peer reviewed

Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea

Jason E. Cohn, George E. Relyea, Srihari Daggumati and Brian J. McKinnon
OTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation, v 3(2), pp 2473974X19851473-n/a
Apr 2019
DOI: https://doi.org/10.1177/2473974X19851473
PMID: 31535073
url
https://doi.org/10.1177/2473974x19851473View
Published, Version of Record (VoR)CC BY-NC V4.0,  Open
url
https://doi.org/10.1177/2473974X19851473View
Published, Version of Record (VoR) Open

Abstract

apnea‐hypopnea index multilevel sleep surgery oxygen saturation nadir pediatric obstructive sleep apnea uvulectomy uvulopalatopharyngoplasty
Objective To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population. Study Design A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017. Setting A tertiary care, university children’s hospital. Subjects and Methods Unpaired Student t test was used to compare average pre‐ and postsurgical apnea‐hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre‐ and postsurgical AHI and OSN within the same patient for the effects of adenotonsillectomy (T&A) vs multilevel sleep surgery. Results In patients who underwent T&A previously, multilevel sleep surgery, including palate procedures, resulted in improved OSA severity in 6 (86%) patients and worsened OSA in 1 (14%) patient. Multilevel sleep surgery, including palate procedures, significantly decreased mean AHI from 37.98 events/h preoperatively to 8.91 events/h postoperatively (P =. 005). However, it did not significantly decrease OSN. Conclusion This study includes one of the largest populations of children in whom palate procedures as a part of multilevel sleep surgery have been performed safely with no major complications and a low rate of velopharyngeal insufficiency. Therefore, palatal surgery as a part of multilevel sleep surgery is not necessarily the pariah that we have traditional thought it is in pediatric otolaryngology.

Metrics

9 Record Views
3 citations in Scopus

Details

Logo image