The study was conducted at the Department of Otolaryngology, Cairo University, Egypt.
Article first published online: 5 SEP 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 11, pages 2563–2567, November 2012
How to Cite
Abdel-Aziz, M. (2012), The effectiveness of tonsillectomy and partial adenoidectomy on obstructive sleep apnea in cleft palate patients. The Laryngoscope, 122: 2563–2567. doi: 10.1002/lary.23507
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 OCT 2012
- Article first published online: 5 SEP 2012
- Manuscript Accepted: 21 MAY 2012
- Obstructive sleep apnea;
- cleft palate;
- Level of Evidence: 4
The most common cause of pediatric obstructive sleep apnea (OSA) is adenotonsillar hypertrophy (ATH). In cleft palate patients, however, the obstructive effects of ATH are more severe due to narrow airways. The aim of this study was to assess the effectiveness of tonsillectomy and/or partial adenoidectomy on OSA in cleft palate patients.
Tonsillectomy and/or partial adenoidectomy was performed in 17 repaired cleft palate patients with tonsillar and/or adenoid hypertrophy and OSA. Apnea/hypopnea (A/H) index and minimum O2 saturation were measured before and after surgery. In addition, because these patients are vulnerable to speech impairment after pharyngeal surgery, auditory perceptual assessment (APA) and nasometric assessment of speech were performed.
The mean preoperative A/H index was 17.6 ± 3.9, and the mean preoperative minimum O2 saturation was 88.7 ± 1.5%. Both parameters improved postoperatively, to 1.9 ± 2.3 and 93.7 ± 1.5% respectively, and the changes were significant (P < 0.001). In 12 cases (70.6%), A/H indexes were normalized following surgery. Associated comorbidities such as retrognathia and narrow pharyngeal airways may underlie incomplete recovery in some cases. There were no significant postoperative changes in APA and nasalance scores.
In most cases, tonsillectomy and/or partial adenoidectomy is an effective method for treatment of OSA in repaired cleft palate patients presenting with tonsillar and/or adenoid hypertrophy. However, some cases may need further procedures to relieve airway obstruction due to associated comorbidities.