SLEEP-APNEA AND SLEEP-RELATED BREATHING DISORDERS IN PATIENTS WITH CRANIOFACIAL SYNOSTOSIS

Seventeen patients with craniofacial synostosis (CFS) have been treate d at the Department of Plastic and Reconstructive Surgery at Osaka Med ical College during the past 10 years. Six patients were thoroughly ev aluated at the Department of Otolaryngology by polysomnography (PSG), cephalometric X-ray and nasopharyngoscopy during sleep. In 4 of the pa tients PSG showed obstructive sleep apnea syndromes (OSAS). Heavy snor ing without apnea and paradoxical respiration were noted in the other 2 patients. Thus, all of the patients had sleep-related breathing diso rders (SRBD). It is assumed that the incidence of SRBD in CFS is high. Cephalometric analysis and profilogram showed maxillomandibular hypop lasia in each patient, and it was assumed that the main cause of SRBD in CFS was stenosis of the upper airway tract caused by maxillo-mandib ular hypoplasia. Nasopharyngoscopy was performed during sleep in 2 pat ients with OSAS secondary to CFS. One patient with adenotonsillar hype rtrophy had nasopharyngeal obstruction and another patient whose poste rior airway space (PAS) on cephalometric radiograph was 3 mm (normal v alue: 11 mm) had obstruction at the tongue base.