Comparison of Pre- and Postoperative Sleep Studies in Patients Undergoing Sphincter Pharyngoplasty

Objective: To determine if sphincter pharyngoplasty changes sleep study parameters on patients undergoing surgery for velopharyngeal insufficiency (VPI). Design: Retrospective chart review on patients undergoing sphincter pharyngoplasty for VPI with pre- and postoperative polysomnography completed. Setting: Institutional study at a tertiary pediatric hospital. Patients: All patients who underwent sphincter pharyngoplasty over a 20-year period were reviewed; all patients with both pre- and postoperative sleep studies were collected for evaluation. Interventions: Sphincter pharyngoplasty for patients with VPI. Main Outcome Measure: Sleep study parameters collected include apnea-hypopnea index (AHI), obstructive and central apneas, hypopneas, and mixed events. The preoperative values were compared to postoperative values. Results: There were 98 patients collected with sleep studies for review. Of these, 32 patients had both pre- and postoperative sleep studies. The AHI increased from 1.8 preoperatively to a postoperative value of 4.8 (P = .004). The number of obstructive events per night went from 4.6 to 17.6 postoperatively (P = .04). The number of hypopneas increased from 4.0 to 13.6 (P = .003). The other parameters were not statistically different, central events decreased from 4.8 to 2.1 (P = .086), and mixed events were essentially unchanged from 0.2 to 0.5 (P = .17) events per night. Conclusions: Patients undergoing sphincter pharyngoplasty for VPI may experience an increase in their postoperative AHI, obstructive events per night, and hypopneas. Sleep studies should be performed both pre- and postoperatively to assess the need for intervention or change in management.