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The Incidence of Sleep Disordered Breathing One Week After Primary Palatoplasty

Evaluation With Overnight Pulse Oximetry

Nakajima, Yukari MD*; Hikosaka, Makoto MD, PhD*; Kuwahara, Kosuke MD*; Kaneko, Tsuyoshi MD, PhD*; Ito, Sukeyuki MD, PhD; Morimoto, Noriko MD, PhD

doi: 10.1097/SCS.0000000000005530
Clinical Study: PDF Only

Background: Sleep disordered breathing (SDB) is defined as a series of disorders including snoring, obstructive sleep apnea, and hypopnea. Few studies investigated the incidence of SDB following primary palatoplasty with objective testing. The aims of this study were to elucidate the prevalence and degree of SDB approximately 1 week following primary palatoplasty with objective testing and to clarify the risk factors.

Method: A retrospective review was performed on children who underwent primary palatoplasty between April 2013 and July 2017 at National Center for Child Health and Development, Tokyo, Japan. As a national center, the authors accept many syndromic patients. The authors keep all patients after palatoplasty intubated and observe them overnight in intensive care unit to reduce the risks of respiratory events. Patients were evaluated with overnight pulse oximetry on 5 to 7 days postoperatively.

Results: Forty-four patients were included, and 30% of the patients were associated with congenital anomaly. Thirteen patients (30%) were diagnosed with SDB. None of the patients required additional treatment after the evaluation. Laryngomalacia and postoperative oxygen requirement significantly correlated with postoperative SDB.

Conclusion: Approximately one-third of the patients may be at the risk of SDB 1 week after primary palatoplasty. Patients with history of laryngomalacia or those who required oxygen support for prolonged time after primary palatoplasty should be cared for significantly high risk of postoperative SDB.

*Department of Plastic and Reconstructive Surgery

Department of Anesthesia

Department of Otolaryngology, National Center for Child Health and Development, Tokyo, Japan.

Address correspondence and reprint requests to Yukari Nakajima, MD, Department of Plastic and Reconstructive Surgery, National Center for Child Health and Development, 2-18-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan; E-mail:

Received 11 September, 2018

Accepted 3 March, 2019

This study was approved by the institutional review board (no. 1598). This work is supported by a grant for Regenerative Medicine in Pediatrics and Obstetrics (29-1) from National Center for Child Health and Development.

The authors report no conflicts of interest.

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© 2019 by Mutaz B. Habal, MD.