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A Survey of the Long-term Effects of Surgery for Velopharyngeal Insufficiency on Sleep
Grant Jameson, BS
Niyant Patel, MD
Ananth Murthy, MD
James Lehman, MD
Akron Children's Hospital
2014-03-13
Presenter: Grant Jameson
Affidavit:
All of the work is original and unpublished.
Director Name: Douglas Wagner
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Objective: To evaluate the long-term effects of surgery for velopharyngeal insufficiency (VPI) on sleep.
Methods: A telephone survey was administered to patients that had surgery performed to correct VPI and were at least 18 years old. The Epworth Sleepiness Scale and Berlin Sleep Apnea Questionnaire's were used.
Results: We were able to contact 32 patients that underwent a posterior pharyngeal flap or sphincter pharyngoplasty to correct VPI. There were 15 males. The mean age at time of survey was 28 years (range, 18-50). 10 patients underwent at least one revision (31%). 17 patients (53%) were deemed high risk for OSA by one of the sleep apnea tools, and 6 patients (19%) were deemed high risk by both. There was an association between a diagnosis of cleft palate alone and high risk of OSA (p=0.02). We were unable to find associations between risk of OSA and pharyngeal flap versus pharyngoplasty, age at time of follow up, history of speech surgery revision, persistent VPI, and family history of OSA. 26 (81%) of the patients surveyed had significant concern about their sleep related health.
Conclusions: Half of patients that underwent surgical VPI correction are high risk for sleep apnea at long-term follow-up. Most of them had some concern about their sleep related health. OSA risk assessments should be regularly performed after surgical correction of VPI, with a low threshold for formal sleep studies in those that are high risk. Our next step is to obtain sleep studies on these 32 patients.
