Evolution of Obstructive Sleep Apnea in Infants with Cleft Palate and Micrognathia
| Autor: | Arastoo Vossough, Justine Shults, Janet Lioy, Ignacio E. Tapia, Allison Thomas, Ruth Bradford, Jesse A. Taylor, Jerilynn Radcliffe, Reza Assadsangabi, Christopher M. Cielo, Carole L. Marcus |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty Polysomnography Micrognathism Comorbidity Severity of Illness Index Cohort Studies 03 medical and health sciences 0302 clinical medicine stomatognathic system Severity of illness Prevalence medicine Humans Prospective Studies Craniofacial Prospective cohort study Philadelphia Sleep Apnea Obstructive medicine.diagnostic_test business.industry Infant 030206 dentistry medicine.disease Scientific Investigations nervous system diseases respiratory tract diseases Cleft Palate Obstructive sleep apnea Neurology Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies Cohort study |
| Zdroj: | Journal of Clinical Sleep Medicine. 12:979-987 |
| ISSN: | 1550-9397 1550-9389 |
| DOI: | 10.5664/jcsm.5930 |
| Popis: | Children with craniofacial anomalies are a heterogeneous group at high risk for obstructive sleep apnea (OSA). However, the prevalence and structural predictors of OSA in this population are unknown. We hypothesized that infants with micrognathia would have more significant OSA than those with isolated cleft palate ± cleft lip (ICP), and those with ICP would have more significant OSA than controls. We postulated that OSA severity would correlate with reduced mandibular size, neurodevelopmental scores, and growth.Prospective cohort study. 15 infants with ICP, 19 with micrognathia, and 9 controls were recruited for polysomnograms, neurodevelopmental testing, cephalometrics (ICP and micrognathia groups) at baseline and a follow-up at 6 mo.Baseline apnea-hypopnea index (AHI) [median (range)] of the micrognathia group [20.1 events/h (0.8, 54.7)] was greater than ICP [3.2 (0.3, 30.7)] or controls [3.1 (0.5, 23.3)] (p = 0.001). Polysomnographic findings were similar between ICP and controls. Controls had a greater AHI than previously reported in the literature. Cephalometric measures of both midface hypoplasia and micrognathia correlated with OSA severity. Neurodevelopment was similar among groups. OSA improved with growth in participants with ICP and postoperatively in infants with micrognathia.Micrognathia, but not ICP, was associated with more significant OSA compared to controls. Both midface and mandibular hypoplasia contribute to OSA in these populations. OSA improved after surgical correction in most infants with micrognathia, and improved without intervention before palate repair in infants with ICP. |
| Databáze: | OpenAIRE |
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