Fatty Hypertrophy Cause Obstructive Sleep Apnea after Fat Injection for Velopharyngeal Incompetence

Intervention Soft tissue augmentation of the posterior pharyngeal wall and the soft palate is reported to reduce velopharyngeal incompetence, and fat grafting in selected patients has shown effective and lasting results for restoring normal resonance. Potential complications of soft tissue augmentat...

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Bibliographic Details
Published in:The Cleft palate-craniofacial journal 2011-07, Vol.48 (4), p.473-477
Main Authors: Teixeira, Rodrigo P., Reid, Julie A., Greensmith, Andrew
Format: Article
Language:English
Subjects:
Abnormalities, Multiple - surgery
Adipose Tissue - transplantation
Autografts - transplantation
Biological and medical sciences
Body fat
Breast Diseases - surgery
Child
Childrens health
Cineradiography - methods
Clinical outcomes
Dentistry
Endoscopy - methods
Fluoroscopy - methods
Follow-Up Studies
Graft Survival
Humans
Hypertrophy
Male
Maxillofacial surgery
Medical sciences
Non tumoral diseases
Otorhinolaryngology. Stomatology
Palate, Soft - surgery
Pharynx - surgery
Pneumology
Postoperative Complications
Respiratory system : syndromes and miscellaneous diseases
Skin & tissue grafts
Sleep apnea
Sleep Apnea, Obstructive - etiology
Speech - physiology
Ulna - abnormalities
Ulna - surgery
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Velopharyngeal Insufficiency - surgery
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Summary:Intervention Soft tissue augmentation of the posterior pharyngeal wall and the soft palate is reported to reduce velopharyngeal incompetence, and fat grafting in selected patients has shown effective and lasting results for restoring normal resonance. Potential complications of soft tissue augmentation for velopharyngeal incompetence include obstructive sleep apnea. Patient An 8-year-old boy with velopharyngeal incompetence and a small velopharyngeal gap underwent a fat injection procedure and subsequently developed obstructive sleep apnea concomitant with a significant weight gain. Videofluoroscopy and nasendoscopy showed a remarkable enlargement of the grafted fat areas that required a soft palate debulking procedure, significantly improving obstructive sleep apnea. Conclusion This is an unusual case where alteration in volume of grafted fat at the recipient site is suspected of causing obstructive sleep apnea. It is also an example of long-term fat graft survival and fat graft overgrowth.
ISSN:1055-6656
1545-1569
DOI:10.1597/09-024