To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population.
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.
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.
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.
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.
Cohn, Jason E.; Relyea, George E.; Daggumati, Srihari; and McKinnon, Brian J., "Multilevel Sleep Surgery Including the Palate in Nonsyndromic, Neurologically Intact Children with Obstructive Sleep Apnea" (2019). Otolaryngology (ENT) Resident Research. 38.