Abstract
The purposes of primary palatoplasty are 1) formation of a muscle sling on the levator veli palatini muscle,2) anatomical repair at the nasopharyngeal area, and 3) narrowing of the nasopharyngeal space by the push back method. After palatoplasty, upper airway resistance increases, but it is considered that palatoplasty rarely causes obstructive sleep apnea (OSAS).
A 3.6-year-old male who suffered from OSAS after palatoplasty for cleft palate visited our hospital on March 20,1991. Palatoplasty was performed on April,1992. A nasopharyngeal airway tube was needed for 5 days postoperatively. Six days later without the nasal tube, upper airway obstruction was not recognized during sleep but snoring remained. He had no speech problem.
However, one year later, when he had a common cold, upper airw ay obstruction was recognized during sleep and he needed a tube for breathing for 6 days. After removal of the tube, airway obstruction during sleep remained, so he returned to our hospital and polysomunography examination was carried out. During sleep, he snored loudly every time due to obstructive apnea. The apnea index was 15.5 (times/hour). Diagnosis: obstructive sleep apnea syndrome
For treatment, the nasal CPAP system was attempted for the reduction of the upper airway obstruction, the result was satisfactory. Snoring and obstructive apnea were reductced by the nasal CPAP system. The apnea index decreased to 3.1 from 15.5. Although he could sleep soundly with this system, the use of this system was conservative therapy. In the future, progressive therapy will be necessary.
